60-year-old female with history of right breast lumpectomy for breast cancer in 1996 followed by recurrence (ILC), in November 2009, underwent right breast mastectomy in January 2010 and left breast reduction surgery in November, 2014 in New Orleans. Patient presents to evaluate a physician palpated lump in the left breast and denies a mammogram, due to discomfort and pain associated with the compression. A targeted left breast ultrasound was performed for the palpable area of concern at 3 to 4:00 position. On physical Examination, a 2-cm lump is palpated. Ultrasound demonstrates a oval mixed echogenic area measuring 1.3 x 0.8 x 1 cm, corresponding to the palpable abnormality, most consistent with area of fat necrosis.
Palpable abnormality in the left breast corresponds to area of fat necrosis. Surgical consultation is recommended. Patient is scheduled to see her plastic surgeon from New Orleans next week. No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bialteral diagnostic mammogram is recommended, due in October 2014. Results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation.