46-year-old female with a left breast cancer, status post neoadjuvant chemotherapy. The patient received a lumpectomy and complete axillary lymph node dissection in 9/2014 at outside institution, but residual left breast cancer and metastatic left interpectoral and left internal mammary lymph nodes were confirmed after surgery. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.The known left breast cancer at 7 o'clock position is smaller, measuring 21 x 22 x 12 mm (AP x ML x CC: previously 32 x 29 x 36 mm). The mass attaches to the pectoralis major muscle.Skin thickening in the left breast is again seen.The enlarged left interpectoral lymph node and left internal mammary lymph node are no longer present. No abnormal left axillary lymph node.No abnormal enhancement is seen in right breast. No abnormal lymph nodes are identified in right axillary region. One normal morphology right axillary lymph node with a marker clip, consistent with proven benign lymph node.
Decrease in size of known left breast cancer.Complete imaging response of left interpectoral lymph node and left internal mammary lymph nodeBIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.