Ms. Cesarz is a 49 year old female with recently diagnosed DCIS of the left breast. She presents for staging MRI for further imaging evaluation. There is heterogeneous amount of fibroglandular tissue in both breasts. Moderate background parenchymal enhancement is noted bilaterally, which limits the sensitivity of this examination.Bilateral retropectoral silicone implants are identified. Susceptibility artifact from biopsy marker clip is identified in the left lower outer breast, at site of biopsy-proven malignancy. There is faint to little enhancement seen around this biopsy marker clip.There is no additional abnormal enhancement seen in the remainder of the left breast or in the right breast. No abnormal lymph nodes are identified in either axillary or internal mammary region.
(1) Unifocal malignancy of the left breast. If breast conservation therapy is desired, wire localization can be performed under mammographic guidance targeting the biopsy marker clip and residual calcifications (if any) in the left lower-outer breast. (2) No MRI evidence for malignancy in the right breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.