Ms. Webb is a 66 year old female with a history of recurrent left breast malignancy. She has a personal history of left breast lumpectomy at the age of 42 years. She presents for MR imaging evaluation after new right chemotherapy. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.In the left lateral breast, far posterior depth, the biopsy proven malignancy demonstrates peripheral enhancement with central necrosis, now measuring approximately 4.1 x 2.4 x 3.2 cm (AP x ML x SI), previously measuring 2.2 x 1.4 x 1.7 cm (on ultrasound from 04/04/2016). Although the mass is quite posteriorly located, there is a discrete fat plane between the mass and pectoralis muscle. The muscle itself is of normal contour and enhancement. Susceptibility artifact from biopsy marker clip is seen centrally within this malignancy.There is no abnormal enhancement seen in the right breast. Postsurgical changes are identified in the left axilla. No abnormal axillary lymph nodes are identified in either axillary region.A right chest wall port is present.
(1) Interval growth of known left breast malignancy while on neoadjuvant therapy, now measuring up to 4.1 cm. (2) No MRI evidence for malignancy in the right breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.