Biopsy proven malignancy in the right breast and axilla. First I Spy research MRI is performed. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.In most of the right superior breast is extensive clumped nonmass enhancement measuring approximately 4.7 x 8.2 x 3.9 cm (AP x ML x SI). Within this region of clumped non-mass enhancement are again seen three irregular masses, which correspond to the masses identified on recent ultrasound exam in the right breast 1:00, 3:00 and 9:00 positions. Post biopsy changes related to the two research core biopsies is identified in the medial aspect of this clumped nonmass enhancement (adjacent to the right 3:00 mass). In addition, there is diffuse skin thickening present of the entire right breast, measuring up to 8 mm in thickness.There is no abnormal MR enhancement identified in the left breast.There are multiple enlarged right axillary lymph nodes identified, the largest of which measures approximately 1.9 cm. One of these enlarged axillary lymph nodes has susceptibility artifact from a biopsy marker clip and adjacent hematoma formation, compatible with recently biopsy proven lymph node. There are no abnormal axillary lymph nodes in the left axillary region.Dual lumen port-a-cath noted in the left chest wall.
Extensive abnormal enhancement in the right breast and axilla as previously seen. Only biopsy related changes in the breast are new since the prior MRI. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.