38 year old female with a known right breast IDC grade 3 with a metastatic right axillary lymph node presents for breast MRI. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.RIGHT BREAST and AXILLA:A known IDC is demonstrated as an irregularly shaped mass, measuring 50 x 39 x 42 mm (AP x LR x CC), at posterior 10:00 position. A marker clip is identified at lateral superior aspect within this mass. There are multiple satellites extending anteriorly from the index mass. Overall size of these lesions is 87 x 59 x 46 mm.Separately from the main cancer, there is an additional, suspicious non-mass enhancement at 8:00 position, measuring 40 x 11 x 15 mm.In the right axilla, a proven metastatic lymph node, measuring 11 mm, is present with a marker clip at superior aspect. There is another abnormally enlarged lymph node, measuring 14 mm, located interior-anterior from the proven lymph node.LEFT BREAST and AXILLA:No abnormal enhancement is seen in left breast. No abnormal lymph nodes are identified in left axillary region.
1. Biopsy proven cancer at right posterior 10:00 position with anterior satellites.2. Suspicious non-mass enhancement in the right breast at 8:00 position. MRI-guided biopsy can be performed, if clinically indicated.3. No abnormal enhancement in left breast. No abnormal lymph nodes in left axillary region. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.