Ms. Dooley submitted outside studies for review. Submitted for review are:-Bilateral breast MRI: 05/10/2016This examination was performed at Little Company of Mary Hospital. Multisequence MRI breast imaging with and without intravenous contrast was performed as per outside MRI breast protocol. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild background parenchymal enhancement is noted bilaterally.RIGHT BREAST:Spanning the entire right superior breast is a large area of clumped non-mass enhancement measuring approximately 4.5 x 2.9 x 2.7 cm (AP x ML x SI). Subtle susceptibility artifact from the two biopsy marker clips are noted in the superior and lateral aspects of this enhancement, compatible with biopsy proven DCIS. The anterior margin of this enhancement is approximately 1.4 cm from the right nipple base. Of note, there is a centrally dilated retroareolar duct seen with high T1 signal intensity internally, which courses through the area of non-mass enhancement. This duct is filled with either hematogenous or proteinaceous products. LEFT BREAST:There is no abnormal enhancement in the left breast.AXILLA:No abnormal axillary lymph nodes are identified in either axillary region.
(1) 4.5 cm area of clumped non-mass enhancement spanning the entire right superior breast, with two biopsy marker clips at the superior and lateral margins, compatible with biopsy proven malignancy. (2) No MRI evidence for malignancy in the left breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.