55 year old with bilateral breast calcifications, status post bilateral stereotactic biopsies. Right breast pathology includes focal ADH. Mild parenchymal enhancement is noted bilaterally. There is heterogeneous fibroglandular tissue. There are hematomas in both breasts, much larger on the left than the right. There are two components to the left sided hematoma, with the left breast biopsy clip located along the lateral aspect of the larger hematoma component. The right breast has a smaller hematoma surrounding the biopsy clip near 12:00. Surrounding each hematoma, there is mild non-mass enhancement including thin rim enhancement. No suspicious nodular or mass like enhancement is present. No area of suspicious kinetic analysis is apparent. No abnormal axillary lymph nodes are identified in either axillary region.Hepatic cysts are noted.
Bilateral breast hematomas (left much larger than right). Enhancement surrounding each hematoma may be reactive secondary to the biopsies, given that no distinct mass-like or nodular enhancement is present. Presuming that the patient has surgery for her right ADH, a 6 month MRI follow up of the left breast is recommended to ensure that the enhancement around the hematoma is resolving by that time.Please note that the suggested follow up MRI can be performed as part of the research MRI study in which she is currently participating.BIRADS: 3 - Probably benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter.