51 year old with large right breast cancer. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally, somewhat of a limitation to the exam.There is abnormal enhancement throughout much of the right upper and inner breast, spanning 7.9 x 5.3 x 4.6 cm. There are associated fluid component areas within this abnormal enhancement suggesting areas of infection and or necrosis. Associated skin thickening of the medial breast is also noted. A Hydromark clip from the recent biopsy is seen within this area of enhancement. There are at least 3 abnormal right axillary lymph nodes, the largest measuring 1.9 x 1.3 cm. This includes an abnormal subpectoral node. No suspicious enhancement is seen in the left breast. Multiple enhancing foci and small benign morphology masses are present scattered through the left breast, but none are uniquely suspicious. No abnormal lymph nodes are identified in the left axillary region.
1. Large region of abnormal enhancement in the right breast measures up to 7.9 cm and is compatible with malignancy with possible superimposed infection. Associated skin thickening is noted.2. Multiple abnormal right axillary lymph nodes.3. Extensive background enhancement. Follow up MRI in 12 months is suggested to ensure stability and because her mammograms are limited by breast density. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.