68 year old female who is status post right lumpectomy (1/23/15) for biopsy proven IDC grade 3, presents for MRI assessment. The pathology results for the recent lumpectomy revealed 2 foci of ILC and extensive LCIS within the specimen in addition to the known IDC. There is scattered fibroglandular tissue in both breasts.Minimal parenchymal enhancement is noted bilaterally.There is a post-operative seroma, 74 x 34 x 32 mm (all measurements: AP x LR x CC) at 6 o'clock position in the right breast from the middle depth to immediate anterior of the pectoralis muscle. Anterior to this seroma cavity, there is an extensive non mass enhancement, measuring 53 x 27 x 41 mm, including a small non mass enhancement (11 x 15 x 5 mm), located 1 cm anterior to the seroma, which shows more distinct contrast. This extensive non mass enhancement extends from the anterior edge of seroma to the nipple. Post surgical changes are seen in the right axilla. No abnormal axillary lymph nodes are identified in right axillary regionNo abnormal enhancement is seen in left breast. No abnormal axillary lymph nodes are identified in left axillary region.
1. Suspicious non mass enhancement in the right breast, extending from the anterior border of seroma to the right nipple. If biopsy is needed for this lesion, MR guided biopsy will be of choice.2. No MR evidence of malignant in the left breast or either axilla.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.