32-year-old female with newly diagnosed extensive left breast carcinoma presents for MRI for staging and surgical planning. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.At the approximate 4 o'clock position of the left breast, posterior depth, there is enhancing, spiculated mass which contains susceptibility artifact from a biopsy clip measuring 1.5 x 1.4 x 1.6 cm with 3 immediately adjacent satellite lesions for total measurement of 2.1 x 2.7 x 1.8 cm. This area corresponds to the patient's known malignancy. Approximately 2.7 cm superior to the aforementioned mass, at the 1 o'clock position of the left breast, there is a second spiculated, enhancing mass which contains susceptibility artifact from a biopsy clip measuring 1.2 x 0.7 x 1.3 cm, corresponding to the patient's known malignancy. Approximately 1 cm anterolateral to the second mass, is a third enhancing mass measuring 0.4 x 0.4 x 0.7 cm. Total area of enhancement in the left breast is 2.5 cm AP x 3.1 cm transverse x 5.6 cm CC.At the approximate 11 o'clock position of the right breast, anterior depth, there is a 2.1-cm hematoma which corresponds to the site of prior benign biopsy. Within the upper outer quadrant of the right breast, mid depth, there is a masslike area of enhancement with washout kinetics measuring 1.4 x 0.7 x 1.0 cm.No abnormal lymph nodes are identified in either axillary region.
1. Multiple enhancing masses within the outer left breast. Total area of enhancement is 2.5 x 3.1 x 5.6 cm. Two of these masses contain susceptibility artifact from biopsy clips, and are compatible the patient's known malignancy.2. Area of masslike enhancement within the upper outer right breast measuring up to 1.4 cm. MR guided ultrasound is recommended for further characterization.3. Hematoma measuring 2.1 cm at the approximate 11 o'clock position of the right breast, corresponding to site of prior benign biopsy.Findings conveyed to Dr. Chhablani at the time of dictation. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.