39-year-old female with new diagnosis of invasive ductal carcinoma. Evaluate for satellite lesion, identified on recent mammogram. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.Right Breast: Within the right breast at 10-11 o'clock, mid to posterior depth, there is a 4.8 x 2.8 x 3.2 cm (AP x ML x CC) irregular heterogenously enhancing mass with type III washout, containing clip artifact from prior biopsy. Multiple adjacent satellite lesions and non mass enhancement is identified anterior, posterior and inferior to it. The most anterior satellite lesion is located retroareolar, measures 6 x 10 x 7 mm (AP x ML x CC) and is mammography occult. This retroareolar satellite is located 4.3 cm anterior to the index lesion. The largest posterior satellite lesion is located at 9:00, posterior depth, 1.9 cm posterior inferior to the index mass, has a mammographic correlate and measures 8 x 7 x 7 mm (AP x ML x CC). The index mass with adjacent satellite lesions and non mass enhancement span 13.0 x 3.8 x 5.3 cm (AP x ML x CC) in total extent.Left Breast: No abnormal enhancement is identified in the left breast. Axillae: No abnormal lymph nodes are identified in either axillary region.
1.Right breast multifocal cancer spanning 13 cm. Right 10:00 index mass, pathology confirmed breast cancer. Multiple satellite lesions, with the largest posterior or anterior satellites that can be further evaluated with MRI directed ultrasound, amenable for ultrasound guided biopsy. 2.No suspicious enhancement within the left breast or axillary regions.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.