Evaluate extent of disease bilaterally, right breast DCIS and left breast IDC with DCIS. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.Left breast: Spiculated heterogeneously enhancing mass in the left breast 12:00 position measures 25 x 15 x 23 mm (AP x ML x CC). Clip artifact is noted within this mass. Located posterior and slightly medial to this mass is a dark T2 signal oval circumscribed mass which demonstrates slow enhancement on postcontrast sequence measuring 11 x 4 x 5 mm (AP x ML x CC) most likely corresponding to the benign morphology fibroadenoma identified on ultrasound and mammogram from outside hospital.Right breast: Clip artifact identified in the right breast 8:00 position posterior depth at the site of stereotactic biopsy. Area of clumped nonmass enhancement identified adjacent to the clip extending anteriorly measuring 46 x 28 x 20 mm (AP x ML x CC). This corresponds to the area of continuous calcifications seen on mammogram. Multiple areas of discontinuous nonmass enhancement and foci are identified anterior, medial and superior to the biopsy-proven DCIS. The most discrete anterior nonmass enhancement which is located 43 mm from the biopsy-proven cancer measures 15 x 13 x 17 mm (AP x ML x CC). It is located in the central breast, anterior to mid depth. The total extent of the anterior discontinuous nonmass enhancement and foci measures 31 x 34 x 26 mm (AP x ML x CC).The total extent from the posterior-most biopsy-proven cancer to the anterior most suspicious focus is approximately 96 mm.Axillae:One enlarged right axillary lymph node measures 14 mm. And enlarged left axillary lymph node measures 16 mm which was probably biopsied at outside hospital. No definite clip identified.
1. Biopsy-proven IDC in left breast 12:00 position measuring 25 mm in maximum dimension.2. Biopsy-proven DCIS in the right breast 8:00 position posterior depth seen in form of nonmass enhancement corresponding to the mammographic area of continuous calcifications (46 mm in maximum AP dimension).Additional suspicious areas of nonmass enhancement and foci identified in the anterior to mid central right breast, approximately 46 mm anterior to the biopsy proven cancer. On reviewing the mammogram, few areas of discontinuous suspicious calcifications (annotated on PACS) are identified in the central anterior to mid right breast that need further evaluation with dedicated spot magnification views and stereotactic biopsy if additional tissue sampling is needed.3. Enlarged right axillary lymph node needs ultrasound for further evaluation.4. Enlarged left axillary lymph node was probably previously biopsied at outside hospital with benign results.BIRADS: 6 - Known cancer.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.