Ms. Zachary is a 61-year-old female with a personal history of bilateral mastectomy in 2012 (right breast-IDC/DCIS, left breast-prophylactic). She completed radiation, chemotherapy, and Femara therapy. Family history of ovarian cancer in mother (diagnosed at the age of 70) and breast cancer in maternal aunt (diagnosed age of 70). She now presents with an enlarged mass in the left axilla. Patient is status post bilateral mastectomy with DIEP reconstruction. There is no abnormal enhancement seen in the right reconstructed breast or chest wall. There is a focal area of skin thickening and associated skin enhancement seen in the left lower outer breast, that measures approximately 3.2 cm in dimension. However, there is no abnormal enhancement seen within the left reconstructed breast or chest wall. No abnormal axillary lymph nodes are identified in either axillary region. Specifically, there is no abnormal enhancement seen in the left axilla, at site of palpable concern.
(1) 3.2 cm span of skin thickening/enhancement in the left lower outer breast. Recommend clinical correlation with physical exam.(2) No MRI evidence for malignancy in bilateral reconstructed breasts and axillae.BIRADS: 3 - Probably benign finding.RECOMMENDATION: C - Clinical Correlation Needed.