Ms. Warren is a 43 year old female with a strong family history of breast cancer in sister (diagnosed at the age of 36) and maternal aunt (diagnosed at the age of 40) and ovarian cancer in maternal grandmother (diagnosed in her 40s). She has no current breast related complaints. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.In the left central to medial breast, there are several new enhancing masses with interspersed non-mass enhancement identified. The total span of abnormal enhancement measures 5.2 x 3.7 x 4.4 cm (AP x ML x SI). The two largest enhancing masses are located in the left medial and left central breast, measuring approximately 2.1 x 0.9 and 1.2 x 0.5 cm respectively.No abnormal enhancement is seen in the right breast. No abnormal lymph nodes are identified in either axillary or internal mammary region.Bilateral small pleural effusions are identified.
(1) New enhancing masses/nonmass enhancement identified in the left central to medial breast, the two largest lesions of which are located in the left medial and left central breast, respectively. An MR directed ultrasound with possible biopsy is recommended for further evaluation.(2) No MRI evidence of malignancy in the right breast. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.