47 year old female with suspicious mass in the left breast with suspicious left axillary lymph node, presents for research MRI scan. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.Highly suspicious, lobulated enhancing mass is demonstrated at posterior 2 o'clock position, measuring 27 x 28 x 30 mm (AP x LR x CC), in the left breast. It is located near pectoralis muscle, but there is a fatty plane between the mass and the muscle. No other suspicious lesions are present in the left breast.In the left axilla, one enlarged lymph node, measuring 23 mm in maximum diameter, with effaced hilum at upper aspect.In the right breast, there is an enhancing mass with possible internal dark septation, measuring 8 x 9 x 9 mm at 3 o'clock position.No abnormal lymph nodes are identified in either axillary region.
1. Highly suspicious mass in the left breast with suspicious left axillary lymph node. Ultrasound guided biopsy were performed for both lesions later today.2. Enhancing mass in the right 3 o'clock position, likely fibroadenoma. MR directed ultrasound, performed later today, detected a correlate, and subsequently biopsy was performed under ultrasound guidance.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: X - No Letter.