29-year-old female with biopsy proven invasive ductal carcinoma at 2 sites in the left breast. There is extreme amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.LEFT BREAST: At the 2:00 position in the posterior left breast, there is an ovoid homogeneously enhancing mass with irregular margins, with artifact from the biopsy clip. This mass measures 18 x 16 x 17 mm (AP X ML X CC). While the lesion abuts the prepectoral fascia posteriorly, no definite enhancement is identified in the underlying pectoralis muscle.At the 3:00 position in the left breast, there is an irregular heterogeneously enhancing mass that measures 21 x 15 x 16 mm(AP X ML X CC), with biopsy clip artifact. This mass is located approximately 13 mm inferior to the mass at the 2:00 position described above.Just posterior to this mass at the 3:00 position there are 2 small enhancing satellite lesions, located medially and laterally. The largest of these satellite lesions located laterally measures 9 x 8 x 10 mm(AP X ML X CC); this lesion also abuts but does not appear to invade the underlying pectoralis muscle. Extensive non-mass enhancement is also noted surrounding the mass at the 3:00 position, extending anteriorly, laterally, and medially.Total extent of the 2 enhancing left breast masses, satellite lesions, and non-mass enhancement is 5.6 x 3.6 x 6.5 cm (AP X ML X CC).RIGHT BREAST: No abnormal enhancement is seen in the right breast. No abnormal lymph nodes are identified in either axillary region.
1.Two left breast masses, satellite lesions, and associated non-mass enhancement, compatible with the patient's known invasive ductal carcinoma with maximum extent of 5.6 x 3.6 x 6.5 cm. The masses/satellites abut but does not definitively invade the underlying left pectoralis muscle; see additional measurements above.2.No abnormality noted in the right breast or axillary regions. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.