54 year old female with history of right breast carcinoma status post lumpectomy in 2004 with chemoradiation and hormone therapy. Family history of breast cancer diagnosed in maternal grandmother at age 52 and ovarian cancer diagnosed in mother. Patient is BRCA 1 positive. Recent 7/31/2014 MRI demonstrated new left 4 mm focus of enhancement in the left central breast that was no longer visualized on 8/4/2014 when attempted MRI guided biopsy. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.Postsurgical changes in the right lateral breast. Benign intramammary lymph node is stable. No new or abnormal enhancement.No abnormal enhancement in the left breast. Stable adjacent normal appearing low left axillary lymph nodes. The focus seen on last year's diagnostic exam does not enhance suspiciously or significantly this year. No abnormal lymph nodes are identified in either axillary region.
No MRI evidence for malignancy. An annual diagnostic mammogram will be due in July 2015. Annual MRI follow up can also be considered. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Routine Diagnostic Mammogram.