72 year old female with known left breast cancer with metastatic left axillary lymph node on neoadjuvant chemotherapy presents to evaluate response. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.The known index cancer with an associated Hydromark biopsy clip is decreasing in size and intensity of enhancement now measuring 16 x 16 x 14 mm (AP X ML X CC). Previously the mass measured 14 x 11 x 17 mm (on 4/29/15) and 29 x 33 x 27 mm (on 1/29/15). Previously described anterior extension of non mass enhancement is not appreciated on today's imaging.The two reference left axillary lymph nodes are also smaller and demonstrate normal morphology. The biopsied node now measures 12 x 12 mm (including the clip), previously measured 14 x 6 mm on 4/29/2015 and 33 x 24 mm on 1/29/2015. The level 2 node now measures 13 x 6 mm, mostly unchanged from most recent study.No additional suspicious or new enhancement is seen in either breast. No abnormal lymph nodes are identified in the right axillary region.A port-a-cath is noted in the right upper chest wall.
Interval decrease in size of left breast mass and normal sized left axillary lymph nodes.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.