A patient submitted outside study for review. Submitted for review are digital mammographic images of left breast (3/9/15), ultrasound images of left breast and left axilla (3/9/15), images from ultrasound guided biopsy of left breast and post procedural left mammographic images (3/10/15) performed at Diagnostic Imaging Specialist of Chicago. DIGITAL MAMMOGRAPHIC IMAGES OF LEFT BREAST (3/9/15):Four spot views of left breast are submitted. No standard views of left breast or no mammographic images of right breast are submitted.The breast parenchyma is heterogeneously dense. Saline implant is present.There are segmentally distributed fine linear calcifications, measuring 49 x 28 mm on CC view, in the left breast at upper outer quadrant.ULTRASOUND IMAGES OF LEFT BREAST AND LEFT AXILLA (3/9/15):There is an irregularly shaped mass, measuring 26 x 13 mm, with marked blood flow at 1 o'clock position, 1 cm from nipple, in the left breast. Two separate oval and round masses, measuring 10 mm and 4 mm, are present adjacent to the main mass. These masses are located within the area of segmental calcifications on mammogram. A lymph node with abnormally thickened cortex is visualized in the left axilla.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF LEFT BREAST AND POST PROCEDURAL LEFT MAMMOGRAPHIC IMAGES (3/10/15):Ultrasound guided biopsy for left 1 o'clock mass and left axillary lymph node (FNA) is performed with appropriate needle placement. Post-procedural mammographic images show that a marker clip placed within the area of calcifications in the left upper outer quadrant.Although the pathology results are not available, the left breast mass and calcifications are highly suggestive of malignancy.
Highly suspicious lesion in the left breast on mammogram and ultrasound, with suspicious left axillary lymph node.MRI is recommended for assessment of the lesion.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: X - No Letter.