43 year old with recent history of stereotactic biopsy of left breast calcifications, with a result of ADH, presents for research MRI. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.There is a segmental non-mass enhancement in the left breast at upper outer quadrant, measuring 30 x 29 x 44 mm (AP x LR x CC), corresponding to the area of amorphus calcifications.In the right breast, there is an enhancing lobulated mass measuring 10 x 7 x 15 mm at 12 o'clock position. No abnormal axillary lymph nodes are identified in either axillary region.
1. Segmental non mass enhancement in the left upper outer quadrant, suggesting malignancy.2. Enhancing mass in the right 12 o'clock position, for which MR directed ultrasound is recommended. If no sonographic correlate is detected, MR guided biopsy should be considered.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.