36 year old with strong family history of breast cancer in her sister at age 26. A palpable area of concern has been noted in the right upper breast. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.There is a large enhancing area in the right upper inner breast. This is located somewhat medial to the area of concern noted by the patient at prior diagnostic imaging. This measures 5.5 x 3.5 x 2.5 cm and approaches to within 5 mm of the pectoralis posteriorly. Scattered cysts are also noted through the right breast. No abnormal enhancement is seen in the left breast. No abnormal lymph nodes are identified in either axillary region.High T2 signal round lesion in the liver is likely benign such as a cyst.
Enhancing area in the right upper inner breast measures up to 5.5 cm and is suspicious for malignancy, possibly ILC. Presuming no palpably guided sampling will be done, repeat ultrasound and probably ultrasound guided biopsy targeting the upper inner breast, more medial than the previous palpable area of concern, is recommended. Donna Christian was informed of the results and recommendations. BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: T - Take Appropriate Action - No Letter.