54-year-old female with history of palpable lump in right breast for 1 year. Patient with strong family history of breast cancer in mother and aunt There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.No abnormal lymph nodes are identified in either axillary region.RIGHT BREAST: There is an oval, lobulated, heterogeneously enhancing mass at 3 o' clock with dark T2 signal measuring 12 x 7 x 11 mm (AP x ML x CC). Additionally, in the right retroareolar region there is an intensely enhancing, multilobulated, possibly intraductal mass measuring 19 x 9 x 9 mm (AP x ML x CC) . This retroareolar mass is approximately 16 mm anterior to the aforementioned 3 o' clock mass.LEFT BREAST: There are multiple enhancing foci in the left retroareolar region; the largest focus measures 6 x 4 x 5 mm (AP x ML x CC).
1.Heterogeneously enhancing 3 o'clock right breast mass as detailed above. Further evaluation of this mass with ultrasound-guided biopsy is recommended.2.Multiple, possibly intraductal enhancing retroareolar foci. Further evaluation with MR directed sonography of the largest focus as detailed above is recommended. If this focus is not visualized on the ultrasound, MR follow-up in 6 months is recommended given the multiplicity of these foci.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.