Repeat Breast Ultrasound Demonstrates Utility with Added Cancer Detection in Patients following Breast Imaging Second Opinion Recommendations

Figure 3

A 60-year-old female presented for second opinion breast imaging interpretation after the percutaneous ultrasound-guided biopsy of a left axillary lymph node revealed metastatic disease favoring primary breast cancer. Second opinion review included bilateral 2-dimensional digital mammography screening study and a bilateral handheld whole breast ultrasound screening study performed after the screening mammogram was read as normal with heterogeneously dense breasts. The outside report recommended ultrasound biopsy for suspiciously enlarged left axillary lymph nodes. The breasts were read as negative in the outside report. On second opinion interpretation of the sonographic images, the radiologist noted a hypoechoic lesion depicted at 12:00 6 cm from the nipple in the left breast (a). Repeat ultrasound for better characterization was performed and depicted an irregular hypoechoic mass spanning 19 mm with angular margins (b). Ultrasound-guided biopsy was recommended and revealed invasive ductal carcinoma.

(a)

(b)