Biopsy proven DCIS in the right breast. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.There is suspicious nonmass enhancement extending primarily anterior and posterior to the posterior biopsy site in the right inner breast. Extent of nonmass enhancement is 4.9 x 1.6 x 1.1 cm. Non-mass enhancement extends to within 5 mm of the pectoralis posteriorly. The anterior extent of nonmass enhancement extends 2.7 cm anterior to the posterior biopsy clip, similar to the extent of residual calcifications visible on post biopsy mammograms. Thin peripheral enhancement is seen surrounding each of the 2 biopsy sites. Inconclusive of the anterior biopsy site, AP measurement is 7.3 cm back to the most posterior area of nonmass enhancement near the chest wall.Elsewhere in each breast, a few scattered enhancing foci are present, though none are uniquely suspicious in appearance or kinetics. There is also a normal sized intramammary lymph node in the far posterior depth of the central inferior left breast.No abnormal lymph nodes are identified in either axillary region.
Nonmass enhancement in the right inner breast measures 4.9 cm AP and extends to within 5 mm of the pectoralis. For needle localization prior to breast conservation, the anterior extent of calcifications or anterior biopsy clip could be localized. The posterior-most extent of calcifications/enhancement may be difficult to localize based on its position near the pectoralis. Given the enhancing foci elsewhere and her dense breasts, an MRI follow up in 1 year to establish stability is recommended. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.