65 year old with right axillary lymph nodes swelling and cluster of powdery calcifications in the left lower inner quadrant. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.LEFT BREAST AND AXILLA:In the left breast at middle 3:30 position, there is an enhancing circumscribed mass measuring 15 x 6 x 5 mm (AP x LR x CC). The mass shows branching-shape, likely intraductal papilloma.No abnormal enhancement is seen in the lower inner quadrant, where powdery calcifications are present. No abnormal lymph nodes are identified in left axillary region.RIGHT BREAST AND AXILLA:In the right axilla, at least four abnormally enlarged lymph nodes along with normal morphology lymph nodes.The largest lymph node measures 25 mm in maximum diameter.No abnormal enhancement is seen in right breast.
1. An enhancing mass in the left breast at 3:30 position. MR-directed ultrasound was performed for this mass and a correlate was detected. Ultrasound guided biopsy for the correlate was performed later today.2. At least 4 abnormally enlarged lymph nodes in the right axilla.3. No abnormal enhancing lesion in the right breast.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.