A patient submitted outside study for review. Submitted for review are bilateral breast MRI performed at Franciscan Alliance.For comparison, screening mammogram dated 7/15/2016, right breast mammograms dated 8/24/2016 and 9/13/2016 and targeted right breast ultrasound dated 8/24/2016 and 9/13/2016 are available. Bilateral breast MRI: Axial T1, T2, STIR, dynamic contrast enhanced images and sagittal STIR sequences of both breasts were submitted for review.There is heterogeneous fibroglandular tissue. There is mild background parenchymal enhancement in both breasts.There is an 8 x 9 x 9 mm enhancing mass in the lower outer quadrant of the right breast, corresponding to the biopsied malignancy. Biopsy clip artifact is seen along the medial aspect of the mass. This mass demonstrates mixed enhancement kinetics with areas of rapid wash in and washout. Approximately 4 mm superoanterior to the index mass, there is a 7 x 4 x 7 mm enhancing mass with persistent enhancement kinetics, concerning for satellite lesion. When measured together, the masses span 1.7 x 0.9 x 2 cm. There are additional scattered enhancing foci in the right breast, which are likely benign.No suspicious enhancing focus or mass in the left breast. There are additional scattered enhancing foci in the right breast, which are likely benign.There are two abnormal right axillary lymph nodes, the largest measuring up to 1.4 x 1 x 1.2 cm. Biopsy clip artifact is seen adjacent to the more lateral node. No abnormal internal mammary or left axillary lymph nodes.
1. An 8 x 9 x 9 mm enhancing mass in the lower outer quadrant of the right breast, corresponding to known biopsied malignancy. An adjacent 7 mm mass is concerning for a satellite lesion.2. Two abnormal right axillary lymph nodes. The more lateral node was previously biopsied with pathology showing invasive ductal carcinoma3. No MR evidence of malignancy in the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.