Ms. Hunt is a 67 year old with recently diagnosed left breast cancer. She presents for MRI for further evaluation. There is scattered fibroglandular tissue in both breasts. Mild background parenchymal enhancement is noted bilaterally.Bilateral retropectoral silicone implants appear intact.In the left lower inner breast, 7:00 position, there is an irregular enhancing mass identified measuring 1.3 x 1.8 x 1.4 cm (AP x ML x SI). Susceptibility artifact from biopsy marker clip is seen just postero-medial to the lesion, compatible with biopsy-proven malignancy. The malignancy abuts against the implant. There is no additional abnormal enhancement seen in the left breast.There is no abnormal enhancement seen in the right breast. No abnormal axillary lymph nodes are identified in either axillary region.
(1) Unifocal malignancy of the left breast, with malignancy abutting against the implant. Of note, the biopsy marker clip is noted just postero-medial to the lesion. If breast conservation therapy is desired, the clip can be used for targeting for preoperative surgical guidance.(2) No MRI evidence of malignancy in the right breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.