67 year old with milky right nipple discharge for several months. Recent ultrasound detected multiple intraductal lesions in the right breast. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.There are multiple enhancing foci in both breasts, right greater than left.There is a linear non-mass enhancing lesion in the right breast at the central aspect, measuring 18 x 4 x 3 mm. This lesion likely corresponds to the elongated intraductal lesion detected on the recent ultrasound study.There are a few enhancing foci in the right breast showing rapid uptake kinetic pattern, which are distinct from others. Those foci are predominantly located in upper inner and upper outer right breast.No abnormal enhancement is seen in left breast. No abnormal lymph nodes are identified in either axillary region.
1. Linear non-mass enhancing lesion in the right breast at the central aspect, which likely corresponds to an elongated intraductal lesion detected on recent ultrasound. Ultrasound guided biopsy is recommended.2. A few enhancing foci in the right breast showing rapid uptake kinetic pattern, which are distinct from others.3. No MR evidence for malignancy in the left breastBIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.