60-year-old woman history of left mastectomy for invasive ductal carcinoma in 2011, no chemotherapy, presents with status post excisional biopsy with pathology showing invasive ductal carcinoma grade 2 involving the dermis and underlying adipose tissue. The patient submitted outside study for review. Submitted for review are breast MRI (7/15/2015) performed at North Shore Hospital. For comparison,standard mammogram (7/8/2014) and ultrasound (6/25/2015) are available. MRI
Known recurrence of malignancy in the left reconstructed breast. Postsurgical changes of left mastectomy and reconstruction with implant intact. Two enhancing foci in the left reconstructed breast correlating with ultrasound findings- an 8 mm mass at the 11:00 position and a 4 mm mass in the 4:00 position.A 6 mm enhancing mass in the right breast 9:00 position is likely an intramammary lymph node. An ultrasound can be performed to further evaluate this finding.Normal axilla bilaterally.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.