A patient submitted outside study for review. Submitted for review are breast MRI (12/8/15) performed at St. Anthony Hospital. There is a biopsy proven DCIS in the left breast. BREAST MRI (12/8/15):The study was performed with a protocol outlined in the outside radiology report.LEFT BREAST:There is a regional non-mass enhancement (NME) in the left breast at upper outer quadrant measuring 31 x 30 x 22 mm (AP x LR x CC), consistent with biopsy proven DCIS. A clip artifact is seen within this NME.Posterior to this NME, there is an enhancing mass measuring 6 x 6 x 9 mm, at posterior 12:00 position. This is possible an additional malignancy, and MR directed ultrasound is recommended. AP distance including NME and this mass is 45 mm.In addition, there is an enhancing focus, which is relatively larger than other enhancing foci, at central left breast.RIGHT BREAST:No abnormal enhancement is seen in right breast. AXILLAE:Axillary regions are somewhat limited in visualization due to artifacts. There are no definitely abnormal lymph nodes in either axillary region.
1. Non-mass enhancement at upper outer quadrant in the left breast, corresponding to the site of proven DCIS. The size of abnormal enhancement is larger than that of clustered calcifications on mammogram.2. Enhancing mass at posterior 12:00 position in the left breast. MR-directed ultrasound with possible biopsy is recommended. If no sonographic correlation is detected, MR guided biopsy should be considered. 3. No MR evidence for malignancy in the right breast or either axilla.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.