Ms. Doss is a 46-year-old female with known right breast invasive ductal carcinoma and metastatic right axillary lymphadenopathy on neoadjuvant chemotherapy presenting for follow-up MR imaging. There is scattered fibroglandular tissue in both breasts. Minimal parenchymal enhancement is noted bilaterally.In the right lateral breast, at site of biopsy-proven malignancy, there has been an interval decrease in the heterogeneously enhancing mass, now measuring 2.1 x 1.5 x 0.9 cm (AP x ML x SI), previously measuring 3.8 x 3.9 x 3.7 cm. A biopsy marker clip is seen centrally within this lesion. Of note, previously noted linear nonmass enhancement extending anteriorly from the biopsy-proven malignancy is not appreciated on today's examination.In addition, there has been an interval decrease in biopsy-proven metastatic right axillary lymph node, now measuring 1.6 cm, previously measuring 4.4 cm. A biopsy marker clip is seen eccentrically within the cortex of this lymph node. No abnormal enhancement is seen elsewhere in the right breast or in the left breast. No abnormal axillary lymph nodes are identified in the left axillary region.
(1) Interval decrease in biopsy proven malignancy in the right breast and biopsy proven metastatic right axillary lymph node. (2) No MRI evidence of malignancy in the left breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.