Ms. Booth is a 40-year-old female with known left breast cancer and metastatic left axillary lymph node. She presents today for MR imaging to evaluate response to neoadjuvant chemotherapy. Minimal parenchymal enhancement is noted bilaterally.Left breast: There has been an interval decrease in size of the biopsy proven malignancy within the left upper outer breast, 2 o'clock position. This malignancy now measures 1.4 x 0.7 x 0.7 cm, compared to 2.0 x 2.0 x 1.9 cm. Previously identified satellite lesions along with linear non-mass enhancement is no longer seen to enhance on today's examination. There has also been an interval decrease in size of previously visualized abnormal lymph nodes in the left axillary and left subpectoral regions. Previously measured left axillary lymph node now measures 0.6-cm, compared to 1.8-cm. The left subpectoral lymph node now measures 0.5-cm, compared to 0.9-cm.Right breast: There is no new abnormal enhancement seen in the right breast. No abnormal axillary lymph nodes are identified in the right axillary region.
1.Interval decrease in size of the primary malignancy with complete imaging response of the satellite lesions and non-mass enhancement in the left breast.2.Interval decrease in size of left axillary lymph nodes.3.No MR evidence of malignancy in the right breast.BIRADS: 6 - Known cancer. RECOMMENDATION: T - Take Appropriate Action - No Letter. 