Patient with unilateral left bloody nipple discharge and breast lump. Family history of cancer. Moderate parenchymal enhancement is noted bilaterally. There are symmetric scattered glandular elements bilaterally.In the left central breast 4 cm behind the nipple, there is an irregularly shaped, homogeneously enhancing mass measuring 2.2 cm AP x 1.5 cm CC x 1.3 cm TV.In the left central breast 6 cm behind the nipple, there is a focus of enhancement measuring 0.7 cm AP x 0.8 cm CC x 0.8 cm TV. In the right central breast 4 cm behind the nipple, there is non-mass enhancement measuring 1.2 cm AP x 0.8 cm CC x 1.0 cm TV. Artifact is noted in the superficial left retroareolar region from a prior-placed biopsy clip. The previously seen fibroadenoma in this region is not evident on MRI. No abnormal axillary lymph nodes are identified in either axillary region.
Three areas of suspicious enhancement bilaterally, most prominently as an irregularly shaped left central breast mass, suspicious for malignancy. MRI-guided ultrasound examination of all 3 regions is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.