Per provided information, the patient is status post ultrasound guided biopsy of a suspicious mass in the right breast. Clip was also placed. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally. There are a few cysts in the right breast.There is extensive abnormal enhancement centered in the right lower inner quadrant. This includes two masses in the posterior depth that measure 8 x 10 x 10 mm and 9 x 10 x 8 mm. Each mass has central artifact suggesting a biopsy clip has been placed in each. The more posterior mass abuts the pectoralis, but the muscle itself enhances normally. Predominately medial to the two masses, there is non-mass enhancement measuring about 4 cm AP. The lateral/posterior extent of the non-mass enhancement also approaches the pectoralis, and the anterior extent approaches the skin. Inclusive of all the suspicious enhancement the extent is 4.4 x 3.1 x 3.8 cm. No abnormal enhancement is seen in the left breast. A few scattered foci are present but no suspicious mass, non-mass enhancement or any area that reaches threshold for kinetic analysis is seen.No abnormal lymph nodes are identified in either axillary region.
Extensive abnormal enhancement in the right breast measuring up to 4.4 cm in total. Correlation with all prior breast imaging and breast pathology is recommended. Presuming that a malignant result has already been obtained, surgical consultation is also recommended. The need for any additional biopsy and method of imaging guidance for any additional biopsy would best be determined after surgical consultation and review of all breast imaging. BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: T - Take Appropriate Action - No Letter.