Ms. Racelis-Paradiso is a 52 year old female with recently diagnosed multicentric malignancy of the left breast (12:00 - IDC/ALH, 2:00 - ILC/LCIS). She presents for MRI evaluation. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild background parenchymal enhancement is noted bilaterally.In the left superior breast, 12:00 location, there is an irregular enhancing mass identified measuring approximately 1.5 x 1.7 x 1.5 cm (AP x ML x SI). Susceptibility artifact from biopsy marker clip is seen within this lesion, compatible with biopsy-proven IDC/ALH. In the left upper outer breast, 2:00 location, there is an additional irregular enhancing mass identified measuring 1.4 x 0.8 x 1.1 cm. Susceptibility artifact from biopsy marker clip is seen immediately anterior to this lesion, compatible with biopsy-proven ILC/LCIS. The distance between the 2 clips measures approximately 5 cm in the AP dimension and 5.7 cm in the AP oblique dimension. There is no additional abnormal enhancement seen in the left breast.There is no abnormal enhancement seen in the right breastNo abnormal lymph nodes are identified in either axillary or internal mammary region.
(1) Multicentric malignancy of the left breast. Biopsy marker clips are separated by approximately 5.7 cm in the AP oblique dimension.(2) No MRI evidence for malignancy in the right breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.