47-year-old female with known IDC with DCIS in the right breast at 2 sites presents for MRI evaluation. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.In the right breast, there are two irregularly shaped enhancing masses; anterior mass (20 x 11 x 18 mm: AP x LR x CC) located at 8:00 position, and posterior mass (11 x 8 x 7 mm) located at 8:30 position. There is a marker clip within each mass. These two masses are not connected each other. There are three enhancing foci immediately anterior and medial to the anterior mass. These foci are possibly satellites. The size of the anterior mass with three foci is 29 x 15 mm (AP x LR) and total AP distance of two masses with three foci is 46 mm.No abnormal enhancement is seen in left breast. No abnormal lymph nodes are identified in either axillary region.
1. Two biopsy proven malignant lesions in the right breast at 8:00 - 8:30 position. Possible satellites anterior and medial from the anterior mass.If conservation surgery is planned, bracketed wire localization by placing one wire at anterior to the anterior mass, and the other wire at the posterior mass under mammographic guidance.2. No MR evidence of malignancy in left breast3. No abnormal lymph nodes in either axillary regionBIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.