57 year old with biopsy proven left breast cancer. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.There is extensive malignant enhancement through much of the left lower inner quadrant, as well as a few additional enhancing areas in the left breast that enhance more than any area in the right breast. The biopsy proven index lesion is seen as an irregular enhancing mass with internal artifact from the Hydromark biopsy clip and measures 3.8 x 2.2 x 2.1 cm. Immediately inferior to the mass is an area of mixed non-mass and mass like enhancement measuring 4.1 x 3.4 x 0.9 cm. In total, these two areas measure up to 5.2 x 3.9 x 4.1 cm. Extending anterior to the index lesion is thin linear non-mass enhancement terminating in a 5 mm focus of enhancement that is located 0.9 cm from the nipple. With the inclusion of this finding, the AP extent of disease is up to 6.5 cm. Additionally, in the left upper outer breast, there is a 1.5 cm area of linear non-mass enhancement. As well, a 4 mm focus in the left lower outer quadrant at mid depth has mixed kinetics.No suspicious enhancement is seen in the right breast.No suspicious lymph nodes are identified in either axillary region.
1. Extensive abnormal enhancement in the left breast. The large area of conglomerate enhancement inclusive of the index lesion and adjacent non-mass enhancement and focus measures up to 6.5 cm in AP extent and extends within 0.9 cm of the nipple. 2. Findings in other quadrants of the left breast as detailed above may not require further work-up depending on surgical/treatment plans. 3. No suspicious axillary lymph node.4. No suspicious enhancement in the right breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.