Ms. Calomese is a 74 year old female presenting with newly diagnosed left breast DCIS. She presents for MRI staging evaluation. There is scattered fibroglandular tissue in both breasts. Moderate to marked background parenchymal enhancement is noted bilaterally, which limits the sensitivity of this examination.In the left inferior breast, far posterior depth, there is an area of linear nonmass enhancement identified measuring approximately 3.0 cm in AP dimension. Susceptibility artifact from biopsy marker clip is now seen at the antero-inferior aspect of this nonmass enhancement, compatible with biopsy-proven malignancy. The distribution and span of this nonmass enhancement approximates the mammographically detected calcifications, measuring slightly larger which is likely related to associated post-biopsy changes. There is no abnormal enhancement seen in the right breast. No abnormal axillary lymph nodes are identified in either axillary region.
(1) Unifocal malignancy of the left breast. A mammographically-guided bracketed wire localization can be performed for preoperative surgical guidance. (2) No MRI evidence of malignancy in the right breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.