Ms. Matesi is a 60 year old female with a personal history of left breast mastectomy in 2012 for IDC/DCIS. Personal history of breast reconstruction with implant placement in 2016. Note that there was technical difficulty with this scan including inadequate fat suppression and patient motion artifact. There is scattered fibroglandular tissue in the right breast. Mild parenchymal enhancement is noted in the right breast. No abnormal enhancement is seen in the right breast. Status post left breast mastectomy with implant-based reconstruction. In the left reconstructed breast, there are two enhancing circumscribed masses identified. The first mass is located in the left upper inner location, 11:00 position, measuring approximately 0.6 x 1.4 x 0.7 cm (AP x ML x SI) and the second mass is located in the left upper outer location, 2:00 location, measuring approximately 0.6 x 0.6 cm (AP x SI). No abnormal axillary lymph nodes are identified in either axillary region.
(1) Two enhancing masses in the left reconstructed breast (11:00 and 2:00 position), which have a benign appearance, perhaps representing fat necrosis. An MR-directed ultrasound is recommended for further evaluation. If no sonographic correlate is identified, then a short term 6 month MRI follow-up may be recommended. (2) No MRI evidence for malignancy in the right breast. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required. 