ADDENDUM: RADIOLOGY AND PATHOLOGY CONCORDANCE REVIEW. PLEASE SEE SEPARATE PATHOLOGY REPORT FOR COMPLETE INFORMATION. Genevieve Woodard (11/27/2023 10:41 AM): PATHOLOGY: A: Breast, right, 9:00, core biopsy - Invasive ductal carcinoma - Nottingham combined histologic grade: 3 Tubule formation: 3 Nuclear grade: 3 Mitotic score: 2 - Invasive carcinoma measures approximately 11 mm in this specimen B: Breast, right, 11:00, core biopsy - Invasive ductal carcinoma - Nottingham combined histologic grade: 2 Tubule formation: 3 Nuclear grade: 2 Mitotic score: 1 - Invasive carcinoma measures approximately 8 mm in this specimen - Minor component of ductal carcinoma in situ, grade 2, solid type, with microcalcifications CATEGORY: Malignant RAD-PATH CONCORDANCE: Concordant RECOMMENDATION: Surgical consult. Please note the UNC breast surgery clinic is being informed of these results and will contact your patient to schedule a clinic visit. The new surgery patient contact number is (984)-974-8116 if your patient does not receive a phone call. SURGICAL DETAILS: The two biopsy areas span over 4 cm craniocaudal (wing and ribbon clips) and could potentially be bracketed if surgically warranted. NOTIFICATIONS: 1. Patient notified of the pathology results and recommendations via telephone by breast Imaging Nurse Navigator Sheri Hilkert on 11/27/2023. 2. NP KATHERINE MCDANIEL KULENIC notified via telephone on 11/27/2023 10:40 AM by breast Imaging Nurse Navigator Sheri Hilkert. EXAM: US BREAST BIOPSY VABB NEEDLE CORE RIGHT, MAMMO POST BIOPSY MAMMOGRAM RIGHT DATE: 11/22/2023 11:27 AM ACCESSION: 20232441196CH, 20232442448CH DICTATED: 11/22/2023 11:41 AM INTERPRETATION LOCATION: Chatham CLINICAL INDICATION: 57 years old Female with RIGHT US CORE BX x2 - R92.8 - Abnormal mammogram. COMPARISON: 11/8/2023 and priors CONSENT: Patient seen, evaluated, and history reviewed. Discussed risks, benefits, alternatives for procedure, and obtained both oral and written informed consent. Patient understands information and questions answered. The roles and responsibilities of care team members, residents, and fellows were discussed. TIME OUT: Immediately prior to starting the procedure, in the presence of the assisting personnel, a procedural pause was conducted to verify correct patient identity, confirmation of correct side and site, confirmation of procedure(s) to be performed, correct patient position as applicable, safety precautions based on patient history or medication use, relevant images and results appropriately displayed, other required items for procedure (medications, implants, devices, special equipment) are readily available, confirmation that expiration date for items is on or after the procedure date, and all image and specimen identifications are correct. TECHNIQUE: Ultrasound guided core needle biopsy. Static images were retained as part of the permanent medical record. Aseptic technique. Local anesthesia with 1% lidocaine. Samples were placed in formalin. Hemostasis was achieved. PROCEDURAL PERSONNEL Attending(s): Genevieve Woodard, MD SITE 1: LESION AND LOCATION: Right breast mass 9:00 7 cm from the nipple BIOPSY APPROACH: Freehand using ultrasound technique . BIOPSY DEVICE: 14 gauge Achieve biopsy needle. NUMBER OF CORES: 4. SPECIMEN RADIOGRAPH: No specimen radiograph was performed. BIOPSY CLIP: ribbon-shaped SITE 2: LESION AND LOCATION: Right breast mass 11:00 6 cm from the nipple BIOPSY APPROACH: Freehand using ultrasound technique . BIOPSY DEVICE: 14 gauge Achieve biopsy needle. NUMBER OF CORES: 5. SPECIMEN RADIOGRAPH: No specimen radiograph was performed. BIOPSY CLIP: wing-shaped POST PROCEDURE DIGITAL MAMMOGRAM: The patient was escorted from the procedure room to the mammography suite for the post biopsy mammogram. Biopsy clip at intended target. MQSA Assessment category: Post Procedure Mammograms for Marker Placement IMMEDIATE COMPLICATIONS: None. PATIENT EDUCATION: Provided by a care team member. Ready to learn, no apparent learning barriers were identified. Post-procedure care explained and patient expressed understanding of the content. IMPRESSION: Successful image-guided needle biopsy and clip placement. When final pathology results are available a report addendum will be issued, which will include radiologic-pathologic concordance and recommendations. Site 1: The ribbon-shaped biopsy site marker is at the intended biopsy site. Site 2: The wing-shaped biopsy site marker is at the intended biopsy site. ATTESTATION: Dr. Genevieve Woodard was present for and performed the entire procedure.