A patient submitted outside study for review. Submitted for review are:Right breast ultrasound with postprocedure mammogram dated 9/28/16 performed at Lynn Sage breast CenterBilateral screening mammogram dated 2/29/2016 with tomo synthesis is available for comparison. Also available are prior mammograms dated 3/11/2015 and 3/10/2014 and 2/18/2013. Right breast ultrasound with postprocedure mammogram dated 9/28/16: Patient presented with a new palpable mass in the right breast.Ultrasound evaluation demonstrated 2 adjacent contiguous masses in the right outer breast for which ultrasound-guided biopsy was recommended.8 mm mass and the adjacent lobulated 17 mm mass at the 9:30 o'clock position of the right breast were targeted under ultrasound. A twirl clip was deployed at the biopsy site. Postprocedure mammogram demonstrates the clip at the site of the mass in the right outer breast.Pathology report revealed right breast 18 mm mass 9:30 o'clock position 3 cm from the nipple, IDC grade 3, largest tumor fragment measures 0.7 cm, microcalcifications overlying blood vessels. This is concordant.As per the report right unilateral diagnostic mammogram with ultrasound was performed on 9/28/2016 before performing the biopsy which have not been submitted.
Biopsy-proven multifocal cancer in the right breast 9:30 o'clock position. Given the dense breast, breast MRI is recommended for staging.Right unilateral diagnostic mammogram and ultrasound performed before biopsy should be submitted for review.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.