40 year old female with biopsy proven left breast cancer with metastatic left axillary lymph node presents for breast MRI. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.LEFT BREAST:There are multiple, irregularly shaped enhancing masses at posterior upper outer quadrant. Most of these masses are connected, and large conglomerated masses are formed. The conglomerated masses measure 59 x 41 x 54 mm (AP x LR x CC), consistent with biopsy proven carcinoma. A marker clip is identified within the masses. In addition to the conglomerated masses, innumerable enhancing foci are present in the upper outer - lower outer quadrant. Those enhancing foci are suspicious for satellites. Total distance of all these lesions is 102 x 68 x 78 mm. Peritumoral edema is present posterior to the conglomerated masses, RIGHT BREAST:No abnormal enhancement is seen in right breast. AXILLAE:In the left axilla, a lymph node with partially enlarged cortex is present at superior aspect, with a marker clip, consistent with proven metastatic lymph node. No other abnormal lymph node is seen in the left axilla.No abnormal lymph nodes are identified in right axillary region.
1. Proven left breast cancer with likely multiple satellites in the upper - lower outer quadrant.2. Proven metastatic left axillary lymph node.3. No MR evidence for malignancy in the right breast or right axilla. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.