History of left mastectomy in 1999 now with positive contralateral (right) axillary node and supraclavicular nodes seen on CT. Assess for right breast lesion. There is scattered fibroglandular tissue in the right breast.Moderate parenchymal enhancement is noted in the right breast.There is linear clumped non-mass enhancement in the right upper outer breast. This measures 3.9 x 0.8 x 1.5 cm. Scattered foci are seen elsewhere, especially in the anterior depth, but these do not enhance as early or to the same degree as the non-mass enhancement mentioned above.In the right axilla, the biopsy proven malignant node has associated clip artifact and measures 2.4 x 1.8 cm. Other normal sized axillary nodes are also seen.No abnormal enhancement is seen in left chest wall. No abnormal lymph nodes are identified in the left axillary region.
1. Linear non-mass enhancement in the right upper outer breast measures up to 3.9 cm. An MRI directed ultrasound is recommended. If no ultrasound correlate is seen, then MRI guided biopsy would be needed for diagnosis.2. Biopsy proven malignant right axillary node measures up to 2.4 cm. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.