A patient submitted outside study for review. Submitted for review is breast MRI (4/11/2015) performed at Little Company of Mary Hospital in Evergreen Park, IL. For comparison, prior mammograms and ultrasounds dating back to February 28, 2015 are available. Bilateral breast MRI was performed per outside hospital protocol without and with gadolinium based contrast.There are scattered fibroglandular tissue with moderate background parenchymal enhancement bilaterally. Multiple foci of enhancement are present throughout both breasts, none uniquely enhancing. An enhancing mass is noted at the approximate 11 o'clock position of the right breast, mid depth, which contains susceptibility artifact from a biopsy clip, compatible with the patient's known malignancy. This mass measures 2.0 x 1.5 x 2.1 cm. Approximately 1.1 cm medial and slightly anterior to the index lesion is a linear area of non-mass enhancement measuring 1.8 x 0.6 x 1.8 cm.No suspicious areas of enhancement are present within the left breast.No abnormal lymph nodes are present within the axillae.
1. Enhancing mass measuring 2.1 cm at the approximate 11 o'clock position of the right breast, compatible with the patient's biopsy proven malignancy.2. Linear area non-mass enhancement within the upper slightly inner right breast. MR guided Second Look ultrasound is recommended for further characterization and possible biopsy. If no sonographic correlate is identified, MR guided biopsy of this area the enhancement is recommended.3. Multiple foci of enhancement throughout both breasts, none uniquely enhancing. Six month follow-up MRI is recommended to assess stability.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.