Patient with biopsy-proven bilateral breast cancer. Presents for staging. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.In the right breast at the 10:00 position at posterior depth there is a heterogeneously enhancing oval mass measuring 24 x 14 x 15 mm (AP X ML X CC) with adjacent clip artifact, compatible with biopsy-proven cancer. 17 mm anteromedial from this mass there is a second lesion of 19 x 15 x 22 mm (AP X ML X CC)nonmass enhancement at the 2:00 position of the right breast, also compatible with malignancy. In total, these 2 lesions span 5.8 cm of the right breast.In the left breast at the 9:00 position there is a spiculated mass measuring 14 x 12 x 18 mm (AP X ML X CC). There is linear extension of this mass anteriorly, posteriorly, and inferiorly spanning a total of 47 x 16 x 30 mm (AP X ML X CC). No abnormal enhancement is seen in the left breast upper outer quadrant in the region of the suspicious calcifications identified on the prior mammogram.Bilateral subcentimeter nonenhancing cysts are noted, right breast greater than left.A single borderline lymph node with thickened cortex is seen in the right axilla, which may be reactive post breast biopsy.
1. Multicentric right breast cancer and extensive NME extending from the biopsy proven left breast cancer spanning 47 mm.2. No suspicious enhancement seen in the left breast upper outer quadrant to correspond to the suspicious calcifications identified on the prior mammogram. If left breast conservation is being considered, tissue sampling of the upper outer quadrant calcifications may be performed.3. Prominent right axillary lymph node most likely reactive. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.