Given the text:
"Bilateral mammography in two planes (CC and MLO) from 15.07.2020
Indication: patient-reported newly emerged painful lump
Clinical question: Diagnostic mammography
Clinical findings: During the clinical investigation, I palpated a round palpable mass in the painful left breast. A small quantity of red-stained mammilla excrete 

Breast composition: both breasts are low density, with a low quantity of glandular tissue. 

The left breast has a visible round mass in the upper outer quadrant, 3 cm in diameter, 4cm distant from the mamilla. A mass has irregular borders, with spiculated parts that invade surrounding tissue. Within a mass, there are several groups of microcalcifications. Altogether, this is a highly suspicious finding for malignancy. The rest of the breast tissues is without significant findings and irregularities. 

The right breast is without pathological changes. 

BI-RADS 5 left
BI-RADS 2 right
Arc Typ B on both sides

Recommendation: urgent clarification with a vacuum-guided biopsy"

Create a synoptic report Do not include the following keywords: quantity, change, quadrant, text
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