74-year-old female with biopsy-proven multifocal right breast invasive ductal carcinoma with metastatic axillary lymph node presents for reevaluation after neoadjuvant therapy. A targeted right ultrasound was performed for the previously identified right breast masses and abnormal right axillary lymph node. In the right breast, 8:00, 3 cm from the nipple, there is a 1.4 x 1.6 x 0.9 cm irregular hypoechoic mass with biopsy clip, previously 1.5 x 1.7 x 2 cm.In the right breast, 9:00, 5 cm from the nipple, there is a 1.1 x 0.5 cm hypoechoic mass. This finding may be a correlate for the previously described 9:00 mass, but is only well seen on one in the transverse dimension. The 9:00 mass previously measured 1.1 x 0.8 x 1 cm.In the right breast, 10:00, 5 cm from the nipple, no sonographic correlates for the two previously described masses are identified.In the right axilla, there is a 1.1 x 0.9 x 1.4 cm abnormal right axillary lymph node with biopsy clip, previously 2 x 1.7 x 1.9 cm.
Interval decrease in size of biopsied right breast 8:00 mass and biopsied right axillary lymph node. Possible correlate for the right breast 9:00 mass is mildly decreased as well. Two previously described masses at the 10:00 position are not visualized.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.