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This is our first case. This is a baseline screening mammogram on a

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40 year old woman in her right breast in the lower central breast

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at middle depth, we notice this finding. This is a two view finding.

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It doesn't meet BI RADS description for a mass, so we would describe

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this as a focal asymmetry. This was given a BI RADS 0 from

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her screening mammogram. I'm going to show it on the tomo so you

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can see how it looks here. So with tomo, we're able to scroll

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through the finding. This is particularly helpful with

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asymmetries and focal asymmetries to determine whether the finding

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represents overlapping breast tissue or a true finding.

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And as you can see, as I scroll

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through the finding, it does seem present on a single slice rather than

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overlapping fibrogandular tissue where it sort of spreads out on multiple

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slices. But as you can see in this slice

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here, I see that finding. Similarly on the MLO view, when I scroll

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through the MLO view, I can see this finding

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in the lower breast that stands out. So this was given a BI RADS 0 and

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we had the patient come back for additional imaging.

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Specifically, we do spot compression views and that's to determine whether

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the finding persists when we're compressing that area of the breast.

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So here are the spot compression CC and MLO views. And again,

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we see that finding here in the central lower breast, which is persisting

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on the spot compression views. When ultrasound was also done and there was

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not a sonographic correlate identified. This is a good indication for a

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BI RADS 3 on mammogram. This is a focal asymmetry on a baseline

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mammogram without a sonographic correlate. This patient was recommended

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to come back in six months. So we had follow ups at six

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months, at 12 months and 24 months as I talked about before.

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And this was the baseline screen. And this was her two year follow

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up exam. And we see that focal asymmetry looks identical.

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In the MLO view also. We see that

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finding here. And then on the two year follow up,

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we see stability. After this finding was stable for two years,

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we were able to conclude that this was a benign finding and change the

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exam to BI RADS 2.