29-year-old female with left invasive ductal carcinoma, for evaluation of response to neoadjuvant chemotherapy. There is extreme amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.Left breast: At the 2:00 position, in the posterior left breast, there is an ovoid homogenously enhancing mass with central clip artifact which has decreased in size measuring 13 x 12 x 12 mm (AP X ML X CC), previously 18 x 16 x 17 mm. There is no evidence of pectoralis invasion. At the 3:00 position in the left breast, there is an irregular heterogeneously enhancing mass that has also slightly decreased in size, measuring 16 x 7 x 16 mm (AP X ML X CC), previously 21 x 15 x 16mm, with biopsy clip artifact. This mass is located inferior to the index mass at 2:00.Additional satellite lesions located more posteriorly at 3:00, and have also decreased in size, with the largest measuring 6 x 7 x 6 mm (AP X ML X CC), previously 9 x 8 x 10 mm. There is non-mass enhancement, which extends anteriorly, but has decreased laterally and medially. The total extent now measures 5.0 x 2.4 x 5.0 cm (AP X ML X CC), previously 5.6 x 3.6 x 6.5 cm. The intensity of the non mass enhancement has also decreased.Right breast: No abnormal enhancement is identified. No abnormal lymph nodes are identified in either axillary region.
Mild to moderate response to neoadjuvant treatment, with decreased size of the index and satellite lesions, and decreased extent of non-mass enhancement.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.