Ms. Durkin submitted outside study for review. Submitted for review is:-Breast MRI: 8/7/2015 This examination was performed at Palos Community Hospital. Bilateral breast MRI was performed using the outside institutions protocol. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.RIGHT BREAST: In the right upper outer breast (posterior depth), there is faint linear non-mass enhancement identified measuring approximately 2.8 cm in maximal dimension. Susceptibility artifact from biopsy marker clip is seen at the posterior aspect of this non-mass enhancement, compatible with biopsy proven malignancy. The MRI extent of enhancement measures larger than the mammographically visualized extent of calcifications (2.8 cm vs 1.4 cm) likely due to associated post-biopsy changes. In addition, in the right central breast, there is an oval enhancing mass measuring 0.7 x 0.5 x 0.6 cm. This enhancing mass is located approximately 5.5 cm anterior to the biopsy marker clip at site of known malignancy. LEFT BREAST: In the left lateral breast, there is susceptibility artifact from a biopsy marker clip, at the site of benign breast biopsy. Associated non-mass enhancement measuring approximately 2.6 cm in maximal dimension is present, likely representing associated post-biopsy changes. No abnormal axillary lymph nodes are identified in either axillary region.
(1) Biopsy proven malignancy in the right upper outer breast with associated post-biopsy related changes. Clip is at the posterior aspect of this enhancement.(2) 0.7 cm enhancing mass in the right anterior central breast. An MR-directed US with possible biopsy is recommended for further evaluation. If no US correlate is identified, then an MR biopsy may be recommended. (3) Benign left breast biopsy with associated post-biopsy related changes. No MR evidence of malignancy in the left breast. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.