58-year-old woman with unresectable right breast cancer present for MRI for treatment planning. Patient initially presented with a palpable right breast mass in 12/24/2015 which was reported at that time to be have been growing in size over the past year. Subsequent biopsy revealed invasive ductal carcinoma grade 3. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.Right breast: Centered in the inferior right breast near 5-6:00 position, posterior depth is a heterogeneously enhancing centrally necrotic mass with associated clip artifact, consistent with biopsy-proven malignancy. This mass measures approximately 4.3 x 4.2 x 5.2 cm (AP x TV x CC) and demonstrates rapid uptake and washout on dynamic evaluation. There is a complete loss of fat planes between the mass and the pectoralis muscle and pectoralis muscle enhancement, consistent with pectoralis muscle invasion. Completely surrounding the mass are areas of nodular and non mass enhancement, suspicious for malignancy. The entire extent of abnormal enhancement including the mass is 9.1 x 5.2 cm in AP and transverse dimension, respectively.Left breast: There is no abnormal enhancement.Axilla: A few axillary lymph nodes are seen in the bilateral axilla, none of which demonstrate abnormal morphology or size. Other: A left chest wall port is noted.
(1) Locally advanced biopsy-proven right breast cancer centered in the inferior right breast with involvement of the pectoralis muscle. The entire extent of abnormal enhancement in the right breast including the biopsy-proven malignancy measures up to 9.1 cm.(2) No MRI evidence for malignancy in the left breast. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.