40 year-old female with left biopsy proven invasive carcinoma in anterior 9 o'clock dominant mass with adjacent smaller satellite mass posteriorly and extensive segmental non-mass enhancement. Patient on neoadjuvant chemotherapy. On postcontrast images, mild parenchymal enhancement is seen bilaterally.Compared to prior outside MRI, there is significant decrease in size and enhancement of the patient's known 9 o'clock anterior index mass, immediately posterior satellite mass, and extensive segmental posterior non-mass enhancement in the left breast. Residual anterior enhancement, which surrounds the biopsy clip, measures 20 x 31 x 30 mm, previously measuring 104 x 59 x 51 mm.Compared to prior examination, there is new left nipple inversion.There is also new superficial focus of enhancement along the left lateral breast skin, which may represent an epidermal inclusion cyst given the high T2 signal seen at this site.No abnormal axillary lymph nodes are identified in either axillary region.
1.Significant interval decrease in size and enhancement of patient's biopsy proven invasive carcinoma of the left breast.2.New left nipple inversion. New left enhancing lateral skin lesion, which may represent an epidermal inclusion cyst. Correlation with physical exam is recommended for both of these findings. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.