A patient submitted outside study for review. Submitted for review are breast MRI (7/16/15), MR-directed right ultrasound images (7/28/15), images from MRI guided right breast biopsy and postprocedural right mammographic images (7/28/15) performed at Palos community hospital. For comparison, digital mammographic images (6/25/15, 7/9/15) are available. BREAST MRI (7/16/15):Breast MRI was performed with a protocol outlined in the outside radiology report.There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.There is an enhancing spiculated mass measuring 23 x 18 x 21 mm (AP x LR x CC) at middle 1:00 position in the left breast. This lesion corresponds to the proven carcinoma. A marker clip is identified at the medial aspect within this lesion.No other abnormal findings are present within the left breast.In the right breast, there is a benign-appearing circumscribed focus measuring 4 mm, at posterior central aspect.No abnormal lymph nodes are identified in either axillary region.MR-DIRECTED RIGHT ULTRASOUND IMAGES (7/28/15):Ultrasound study for the right breast was performed and failed to detect a sonographic correlate with an enhancing focus.IMAGES FROM MRI GUIDED RIGHT BREAST BIOPSY AND POSTPROCEDURAL RIGHT MAMMOGRAPHIC IMAGES (7/28/15):MR-guided biopsy of the benign-appearing circumscribed focus at right posterior central aspect was performed. A needle placement appears appropriate. A marker clip is located at the expected location on the post-procedural mammogram.The pathology result was fibroadenoma, which is concordant.
1. Unifocal cancer in the left breast on MRI.2. Biopsy proven fibroadenoma in the right breast. No MR evidence of malignancy in the right breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.