56 year old female with metastatic left axillary lymph nodes and palpable left breast mass presents for MRI evaluation. There is heterogeneous amount of fibroglandular tissue in both breasts.Several cysts are noted in the left breast.Mild parenchymal enhancement is noted bilaterally.There is an irregularly shaped enhancing mass in the left breast at posterior 2 o'clock position, measuring 19 x 12 x 11 mm, which is suspicious for malignancy.There is an additional enhancing mass, measuring 9 x 6 x 9 mm, at posterior 12 o'clock position in the left breast.Surgical changes are seen in the left axilla. Multiple enlarged lymph nodes are present in the left axilla, mainly in level one and two. The largest lymph node measures 28 mm in maximum diameter.No abnormal enhancement is seen in right breast. No abnormal lymph nodes are identified in right axillary region.
1. Suspicious mass in the left posterior 2 o'clock position and additional enhancing mass in the left posterior 12 o'clock position.2. Multiple abnormal lymph nodes in the left axilla.3. No abnormal enhancement in right breast. 4. No abnormal lymph nodes in right axillary region.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: X - No Letter.