45 year old with recently diagnosed ILC in the left upper outer quadrant (3 sites). Evaluate extent of disease. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.Left breast:In the 3 o'clock radian, mid-depth, corresponding to the site of the coil clip there is focal non-mass enhancement measuring 14 x 11 x 13 mm (AP x transverse x CC).In the 3 o'clock radian, posterior depth, corresponding to the site of the ribbon clip there is focal non-mass enhancement measuring 13 x 10 x 10mm (AP x transverse x CC).In the 2 o'clock radian, posterior-depth extending into the axillary tail, corresponding to the site of the wing clip there is focal non-mass enhancement measuring 5 x 6 x 5 mm (AP x transverse x CC).In total the areas of enhancement extending along the lateral border of the left breast measure 34 x 14 mm. The biopsy clips are positioned centrally within the corresponding lesions. No additional sites of abnormal enhancement in the left breast. The anterior ducts contain high T1 signal fluid likely related to prior biopsy.Right breast:In the 12 o'clock radian, mid-depth, there is a 4 mm focus of enhancement which demonstrates washout kinetics. No additional abnormal enhancement in the right breast.Axilla:No axillary lymph nodes bilaterally.
1. 3 regions of non-mass enhancement extending along the lateral aspect of the left breast corresponding to the sites of the patient's biopsy proven invasive lobular carcinoma. No additional foci of abnormal enhancement in the left breast.2. 4-mm focus of abnormal enhancement within the right upper central breast. MRI guided biopsy is recommended for further evaluation. No additional foci of abnormal enhancement in the right breast.3. No abnormal axillary lymph nodes bilaterally.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.