68 year old female with newly diagnosed right breast cancer at upper outer quadrant (2 sites) and with a proven benign lesion in the right breast, presents for breast MRI study. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.In the right breast, there are three abnormally enhancing masses in the posterior 11:00 position. Most superior mass (#1) measures 19 x 19 x 12 mm (AP x LR x CC), and this is a proven IDC with a venus clip. Second mass is located between #1 and #3 masses, measuring 29 x 12 x 19 mm, with a ribbon clip, and this is another biopsy proven IDC. #3 mass is located most inferiorly, measuring 13 x 11 x 10 mm. Overall measurement of these three masses is 34 x 29 x 38 mm.There is a small clip artifact from recent benign biopsy at anterior 10:00 position in the right breast.There is a non enhancing benign mass in the central right breast.No abnormal enhancement is seen in left breast. No abnormal lymph nodes are identified in either axillary region.
1. Two biopsy proven cancers and one suspicious mass in the right breast at posterior 11:00 position. If conservation surgery is planned, bracketed wire localization for the most superior mass (#1 with venus clip) and most inferior mass (#3: non-biopsied) is recommended. #3 mass corresponds to the mass annotated as #3 in the ultrasound study performed on Sep 21, 2016. This mass is also seen on mammogram.2. No abnormal enhancement in left breast. 3. No abnormal lymph nodes in either axillary regionBIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.