Ms. Brown is a 66 year old female with newly diagnosed right breast cancer in two locations. She has a family history of breast cancer. Preoperative MRI is requested at this time. There is heterogeneous amount of fibroglandular tissue in both breasts.There are scattered foci of enhancement seen in both breasts, compatible with mild background parenchymal enhancement. However, no one focus is more suspicious than the rest. In the right upper outer breast, there are two areas of mass-like enhancement identified, that correspond to the two biopsy-proven malignancies. - The first area of mass-like enhancement is in the 11:00 location, measuring approximately 1.6 x 0.9 x 1.5 cm. A biopsy marker clip is seen at the peripheral aspect of this enhancement. - The second area of mass-like enhancement is in the 10:00 location, measuring approximately 1.4 x 1.3 x 1.7 cm. This measures slightly larger on the MRI, likely due to related post-biopsy changes. Of note, a 1.2 cm hematoma with increased T1 signal is identified just abutting the inferior aspect of this area of enhancement. A biopsy marker clip is also seen at the peripheral aspect of this area of enhancement. - Total span of enhancement measures 3.2 x 3.1 x 2.9 cm (AP x ML x CC). The two biopsy clips are separated by approximately 2.0 cm.There is no additional site of abnormal enhancement seen in the right breast. There is no abnormal enhancement seen in the left breast. No abnormal axillary lymph nodes are identified in either axillary region.
Biopsy proven multifocal breast cancer in the right breast. No additional MR evidence of malignancy identified. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.