50-year-old with left breast IDC and left axillary metastatic lymph node disease. MRI per highest PY to protocol There is an extreme amount of fibroglandular tissue in both breasts. On postcontrast images, moderate parenchymal enhancement is seen bilaterally.The T2 precontrast sequences again demonstrate extensive bilateral cystic disease, right greater than left.LEFT BREAST:The index enhancing irregularly marginated mass lesion in the 3:00 radian mid depth measures 2.3 x 2.2 x 2.4 cm (AP by transverse by CC), previously 2.6 x 2.3 cm. A biopsy clip artifact is present in the center of the mass.There is a satellite enhancing mass in the 6:00 radian anterior to middle depth measuring 11 x 7 x 11 mm, previously 12 mm in maximum dimension. This contains artifact from a biopsy clip.In the anterior breast 7:00 radian there is a satellite enhancing mass measuring 6 x 8 x 8 mm, previously 8 mm in maximum dimension.There is an additional enhancing mass located 14 mm posterior to the index mass in the 2:00 radian mid to posterior depth that measures 9 x 9 x 10 mm. This is more readily visualized than on the previous study.The total extent of disease measures 6.7 cm in craniocaudal dimension and 4.4 cm anterior to posterior.RIGHT BREAST:No suspicious mass lesions or areas of enhancement.AXILLAE: Again noted are two enlarged and enhancing left axillary lymph nodes. The largest of these contains postbiopsy change and metallic clip artifact. It measures 2.5 x 2.1 cm, previously 3 cm in maximum dimension. No abnormalities noted in the right axilla.
1. Biopsy-proven cancer in the left breast. 3 enhancing satellite nodules are also not significantly changed. Total extent of disease is 6.7 x 4.4 cm.2. Slight interval decrease in size of left axillary lymphadenopathy corresponding to biopsy-proven metastatic disease.3. No abnormal enhancement or mass lesions in the right breast and right axilla.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.