53 year old woman with history of left breast cancer. There is scattered fibroglandular tissue in both breasts.Minimal parenchymal enhancement is noted bilaterally.This exam is somewhat limited by motion artifact. The index lesion is a round, circumscribed mass in the left breast at 1:00 position, middle depth which enhances and measures 2.0 x 2.0 x 1.9 cm. Focus of T2 hyperintensity immediately lateral to this lesion represents the Hydromark biopsy clip. An addition, poorly marginated focus of enhancement measuring 0.5cm is seen in the central left breast, middle depth, representing a satellite lesion. Adjacent signal void represents the second biopsy clip. The extent of breast tissue spanned by these lesions measures 5.2 cm in craniocaudal dimension. An enlarged, abnormal morphology lymph node is partially visualized in the left axilla measuring 3.4 x 1.9 cm. Artifact from biopsy clip noted.In the right breast, there is an enhancing 1.4 x 0.9 cm oval, circumscribed mass at the 9:00 position, posterior depth. Normal-appearing lymph nodes are noted in the right breast and axilla. A T2 hyperintense lesion in the right lobe of the liver is noted and likely represents a hemangioma as seen on CT from 2007.
1.Left breast mass with additional satellite focus of abnormal enhancement both of which are biospy proven malignancies.2.Abnormally enlarged left axillary lymph node which has been biopsied.3.Mass in the right breast which may be benign in etiology such as a fibroadenoma. MR directed ultrasound is recommended for further evaluation.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.