Ms. Hymon is a 66 year old female presenting for MRI evaluation of screen detected lesion in the left breast. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.LEFT BREAST: In the left breast 12:00 location, there is an irregular enhancing mass is identified measuring 0.9 x 0.8 x 1.1 cm. This likely corresponds to the mammographically detected area of architectural distortion.Seen just less than one centimeter posterior to this lesion is an enhancing focus measuring 0.5 cm, suspected to be a satellite lesion. The total span of abnormal enhancement (index malignancy + suspected satellite lesion) measures 2.2 cm in the AP dimension. RIGHT BREAST:There is no abnormal enhancement seen in the right breast. AXILLAE:No abnormal axillary lymph nodes are identified in either axillary region.
(1) 1.1 cm enhancing mass in the left superior breast, corresponding to the mammographically detected area of architectural distortion. A percutaneous biopsy with clip placement is recommended for further evaluation.(2) An enhancing focus seen just posterior to the index malignancy is suspected to be a satellite lesion. An MR-directed ultrasound with possible biopsy is recommended for further evaluation.(3) No MRI evidence for malignancy in the right breast. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.