35-year-old female with recently diagnosed breast cancer, concern for abscess post biopsy. There is heterogeneous amount of fibroglandular tissue in both breasts.Marked parenchymal enhancement is noted bilaterally, a limitation to the exam. The enhancing index right breast mass at 1:00 measures 3.9 x 3.7 x 3.8 cm. Medial to the mass there is a peripherally enhancing collection measuring 2.3 x 1.3 x 1.7 cm with adjacent skin thickening and central susceptibility artifact suggesting clip migration to within the collection.Two possible satellite lesions posterior to the index mass measure up to 1.5 and 0.9 cm respectively. There is an enlarged heterogeneously enhancing right axillary lymph node which measures 2.9 x 1.9 cm.In the left breast there is a 1.1 x 0.7 x 1.1 cm small enhancing mass at 12:00. At 11:00 in the left breast an additional small enhancing 1.0 x 0.9 x 1.1 cm mass is noted.Note is made of a likely hepatic cyst.
1. Superficial loculated enhancing fluid collection/abscess medial to the index cancer with adjacent inflammatory changes as described above. The biopsy clip appears to have migrated into the collection. 2. Index right breast cancer measures up to 3.9 cm and has two possible satellite lesions present posteriorly. As well, a suspicious right axillary lymph node is seen. MRI directed ultrasound is recommended. 3. Small enhancing masses in the upper left breast for which second look ultrasound is recommended. Findings were discussed with Dr. Jaskowiak.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.