Ms. Findley is a 57 year old female with a known history of left breast malignancy currently being treated with neoadjuvant chemotherapy. She presents for MRI evaluation to assess for treatment response. There is scattered fibroglandular tissue in both breasts. Mild background parenchymal enhancement is noted bilaterally.Susceptibility artifact is identified in the left upper outer breast, at site of biopsy proven malignancy. There is very faint enhancement seen associated with clip measuring approximately 0.7 x 0.7 x 1.0 cm (AP x ML x SI), previously measuring 2.0 x 1.9 x 2.9 cm.Biopsy clip artifact from prior benign biopsy is seen in the left upper outer breast with no associated abnormal enhancement. There is no abnormal enhancement seen in the right breast. No abnormal axillary lymph nodes are identified in either axillary region.
(1) Interval decrease in size of index malignancy in the left breast. If breast conservation therapy is desired, the small bar clip can be used as targeting for preoperative surgical guidance. (2) No MRI evidence of malignancy in the right breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.