46 year old with biopsy proven DCIS in left breast presents for staging MRI. There is heterogeneous amount of fibroglandular tissue in both breasts.Multiple cysts are present in both breasts, left greater than right.Moderate parenchymal enhancement is noted bilaterally.There is an irregularly shaped, spiculated enhancing mass at posterior 5 o'clock position in the left breast, measuring 14 x 17 x 21 mm (AP x LR x CC). This enhancing mass is located within the area of multiple clustered cysts. Focal non mass enhancement is present from this mass toward superior lateral direction, and overall measurement including mass and non mass is 22 x 26 x 26 mm. A marker clip is located within the non mass portion of this enhancement.No abnormal enhancement is seen in right breast. No abnormal lymph nodes are identified in either axillary region.
1. Irregularly shaped mass with non mass enhancement at posterior 5 o'clock position in the left breast. As a marker clip is present at the non mass enhancement of this lesion, this portion likely corresponds to proven DCIS. The mass portion might be an invasive component. If clinically indicated, repeat ultrasound study and biopsy can be performed.2. No MR evidence for malignancy in right breast or either axillary region. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.