Ms. Greer is a 39 year old female with known left breast cancer currently on neoadjuvant chemotherapy. She presents today for imaging evaluation as part of the I-SPY2 protocol. Personal history of benign left breast biopsy in the 6:00 location in 9/2016 for stromal fibrosis. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.In the left retroareolar region, the known malignancy now measures approximately 4.6 x 4.4 x 5.2 cm (AP x ML x SI), previously measuring 4.1 x 4.5 x 4.5 cm. The malignancy continues to extend towards and involve the anterior skin and nipple. The biopsy marker clip is seen peripherally at the anterior aspect of the malignancy.No abnormal enhancement is seen in the right breast. Specifically, no heterogeneous enhancement is seen in the right breast, which was seen on prior MRI.Two enlarged left axillary lymph nodes continue to be seen, the larger one of which measures 3.0 x 1.7 cm, previously measuring 3.0 x 1.8 cm. A biopsy marker clip is seen within this lymph node, with benign pathology. No abnormal lymph nodes are identified in the right axillary or internal mammary region.
(1) Slight interval increase in size of known malignancy of the left breast. Stable left axillary lymph node with benign pathology results.(2) No MRI evidence for malignancy in the right breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.