Ms. Dazzena is a 60-year-old female with known right breast cancer IDC and metastatic right axillary lymph node. She presents today for MRI #4 per ISPY-2 protocol. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild background parenchymal enhancement is noted bilaterally.RIGHT BREAST:There is no residual enhancement identified in the right upper inner breast, at site of biopsy-proven malignancy. Susceptibility artifact from biopsy marker clip is seen within the central aspect of a normal-appearing right axillary lymph node, measuring 1.1 cm, compared to 1.1 cm.LEFT BREAST:No abnormal enhancement is seen in the left breast. No abnormal axillary lymph nodes are identified in the left axillary region. Vascular port identified in the left medial chest wall.
(1) No residual abnormal MR enhancement identified in the right upper inner breast, at site of biopsy-proven malignancy. However, on the same-day diagnostic workup, there are extensive residual pleomorphic calcifications seen in the right upper inner breast, that span approximately 9 cm in maximal dimension. These calcifications extend to within 1 cm from the right nipple base. (2) No MRI evidence of malignancy in the left breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.