Ms. Bosby is a 33 year old with proven left breast cancer presents for research MRI (I-SPY #4). There is extreme amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.LEFT BREAST: The known left breast cancer shows a minimal interval decrease in size, now measuring 57 x 59 x 93 mm (AP x LR x CC, previously 57 x 61 x 98 mm). Although only measuring mildly smaller when compared to the prior exam, the overall enhancement pattern of this tumor has now markedly decreased. Compared to solid heterogenous enhancement of the tumor, there are now multiple diffuse masses/foci evident, compatible with treatment-related changes. Diffuse edema and skin thickening is similar to the prior exam. A Hydromark clip is again identified at the anterior 12 o'clock position within the tumor in the left breast.A known metastatic left axillary lymph node with Hydromark clip now measures 1.1 cm in maximum diameter (previously 1.4 cm). RIGHT BREAST: There is no abnormal enhancement seen in the right breast. Multiple small cysts are present in the right breast. No abnormal axillary lymph nodes are identified in the right axillary region.
(1) Mild interval decrease in size of known left breast cancer with overall marked decrease in previously seen solid/heterogenous enhancement pattern, compatible with treatment-related response. (2) Interval decrease in size of metastatic left axillary lymph node.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.