Ms. Dazzena is a 60-year-old female with known right breast cancer IDC and metastatic right axillary lymph node. She presents today for MRI #3 per ISPY-2 protocol. There is scattered fibroglandular tissue in both breasts. Minimal parenchymal enhancement is noted bilaterally.RIGHT BREAST:There is no residual enhancement identified in the right upper inner breast, at site of biopsy-proven malignancy. Susceptibility artifact from biopsy marker clip is seen within the central aspect of a normal-appearing right axillary lymph node, now measuring 1.1 cm, compared to 1.1 cm.LEFT BREAST:No abnormal enhancement is seen in the left breast. No abnormal axillary lymph nodes are identified in the left axillary region. Vascular port identified in the left medial chest wall.
(1) No residual abnormal enhancement identified in the right upper inner breast, at site of biopsy-proven malignancy. If breast conservation therapy is desired, a repeat post-therapy mammogram is recommended at this time to delineate the presence and extent of previously mammographically-seen calcifications in the right upper inner breast. A bracketed wire localization may be required depending on the mammographic findings.(2) No MR evidence of malignancy in the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.