Ms. Toporski is a 59-year-old female with biopsy-proven malignancy of the left breast. She presents today for MR imaging for further evaluation. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.In the left lower outer breast, there is an enhancing spiculated mass identified measuring 0.8 x 0.8 x 0.6 cm (AP x ML x SI). Susceptibility artifact from biopsy marker clip is located immediately inferior to this mass, compatible with biopsy-proven malignancy. There is no additional abnormal enhancement identified in the left breast.Few scattered enhancing foci are identified in the right breast, one of which contains internal fat, and likely represents a benign intramammary lymph node. Although none of the additional foci are particularly suspicious in appearance, they are asymmetric in quantity when compared to the left side (right > left). No abnormal axillary lymph nodes are identified in either axillary region.
(1) Unifocal malignancy of the left breast. Biopsy marker clip is located immediately inferior to this mass, and can be used for preoperative surgical guidance if breast conservation therapy is desired.(2) Scattered foci of enhancement seen in the right breast, for which a short term 6 month follow-up MRI is recommended in order to confirm stability of these findings.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.