Ms. Lee is a 68-year-old female with biopsy-proven multicentric disease of the right breast (IDC/DCIS). She presents today for MR imaging for further evaluation. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.RIGHT BREAST: No abnormal enhancement is seen in the right breast. No abnormal axillary lymph nodes are identified in the right axillary region.LEFT BREAST:There is extensive clumped nonmass enhancement identified in the left lateral breast, measuring approximately 7.1 x 3.0 x 3.7 cm (AP x ML x SI). This enhancement extends up to the left nipple base. Susceptibility artifact from Hydromark clip is seen in the central aspect of this clumped nonmass enhancement. Susceptibility artifact from ribbon biopsy marker clip is seen at the posterior aspect of this enhancement. The distance between the 2 clips on the diagnostic mammogram is approximately 5.3 cm in the AP dimension. No abnormal axillary lymph nodes are identified in the left axillary region.Few scattered nonenhancing T2 hyperintense lesions are identified in the liver, which may represent simple cysts versus hemangiomas.
(1) 7 cm span of abnormal clumped non-mass enhancement in the left breast, extending up to the left nipple base, corresponding to the mammographically detected abnormality. Two biopsy marker clips are located approximately 5.3 cm apart in the AP dimension.(2) No abnormal left axillary lymph nodes.(3) No MRI evidence of malignancy in the right breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.