47 year old female with biopsy proven IDC, grade 2, at two sites in the right breast, presents for staging MRI. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.RIGHT BREAST:In the right breast, there is an ill-defined, irregularly shaped mass is present at middle 11:00 position, measuring 20 x 26 x 20 mm (AP x LR x CC), with internal marker clip (Hydromark clip). This is a proven IDC. There is non-mass enhancement extending from this mass anteriorly to the nipple, and posteriorly near the pectoralis muscle, at upper outer quadrant. The nipple is retracted. The non-mass enhancement ia associated with multiple small masses and foci. Another marker clip is seen within this non-mass enhancement at retroareolar region. Overall measurement of this lesion is 101 x 49 x 58 mm. LEFT BREAST:No abnormal enhancement is seen in left breast. AXILLAE:No abnormal lymph nodes are identified in either axillary region.
1. Extensive non-mass enhancement with multiple masses and foci at upper outer quadrant in the right breast. Two clips, both at the site of proven IDC, are present within this extensive lesion. The lesion extends to the nipple.2. No MRI evidence of malignancy in the left breast3. No abnormal lymph node in either axillaBIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.