32-year-old female with bilateral breast pain, greater on the left. Family history of breast cancer diagnosed in two paternal aunts. Patient underwent diagnostic mammography and left ultrasound the prior day demonstrating left 12 o'clock duct dilatation with possible intraductal mass. There is scattered fibroglandular tissue in both breasts.Minimal parenchymal enhancement is noted bilaterally.LEFT:Non-mass enhancement in the left retroareolar breast, predominantly due to ductal wall enhancement, with associated ductal dilatation. Total extent of retroareolar non-mass enhancement measures 5.9 x 6.7 x 9.7 cm (AP x TR x CC). In the 12 o'clock position, there is superimposed more focal rounded peripheral duct enhancement that measures approximately 8 mm, that likely correlates with the 12 o'clock sonographic finding. No definite enhancing mass is identified. Mildly prominent left upper outer breast intramammary and axillary lymph nodes may be reactive in etiology. These maintain fatty hila.RIGHT:No abnormal enhancement is seen in the right breast. No abnormal lymph nodes in the right axillary region.
1.Left retroareolar non-mass enhancement, predominantly due to ductal wall enhancement with ductal dilatation. Superimposed more focal ductal dilatation in the 12 o'clock position likely corresponds to the sonographic findings in that location. No enhancing mass identified. Findings may be related to a ductal inflammatory process, though malignancy is not excluded. The patient is going to have ultrasound guided biopsy of the left 12 o'clock region. 2.Prominent likely reactive left sided lymph nodes.3.No abnormal enhancement in the right breast or axillary region.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.