54-year-old female with segmentally distributed pleomorphic calcifications in the left breast, biopsy of which proved ADH worrisome for DCIS. The patient presents for technical repeat MRI study. There is scattered fibroglandular tissue in both breasts.Marked parenchymal enhancement is noted bilaterally.There is segmental non-mass enhancement at 6:00 - 8:00 position in the left breast, measuring 100 x 41 x 19 mm (AP x ML x CC).Because of the marked parenchymal enhancement, this non-mass enhancement is only seen on ultrafast imaging. A marker clip is identified at posterior lateral and inferior aspect of the lesion.No abnormal enhancement is seen in right breast. No abnormal lymph nodes are identified in either axillary region.
1. Suspicious segmental non-mass enhancement in the left breast at 6:00 - 8:00 position. Stereotactic biopsy for calcifications located at 6:00 position (anteromedial from the marker clip) is recommended for tissue diagnosis. Before stereotactic biopsy, ultrasound for left breast can be performed to look for possible target for biopsy.2. No MRI evidence for malignancy in the right breast3. No abnormal lymph nodes in either axillary regionBIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.