Ms. Flores is a 37 year old female with known right breast cancer undergoing neoadjuvant chemotherapy. She presents today for MRI evaluation to assess for response. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.A vascular port is present in the left medial chest wall.There has been an interval decrease in enhancement of known malignancy in the right breast, 3:00 location. At present, there are a few faint enhancing foci seen in this area, spanning approximately 2.1 x 0.5 x 1.4 cm (AP x ML x SI), previously measuring 1.8 x 2.0 x 2.1 cm. Susceptibility artifact from biopsy marker clip is seen centrally within these foci.No abnormal enhancement is seen in the left breast. No abnormal axillary lymph nodes are identified in either axillary region.
Few residual enhancing foci in the right central breast, spanning approximately 2.1 cm in the AP dimension. Biopsy marker clip is located centrally within these foci.If breast conservation therapy is desired, a bracketed wire localization targeting the mammographically seen biopsy marker clip/density/calcifications can be performed. The span of density/calcifications approximates the MR findings, measuring approximately 2.3 cm in the AP dimension.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.