32-year-old woman with a newly diagnosed right breast cancer metastatic to a right axilla lymph node presents for staging. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.Right Breast: In the lower outer quadrant, there are multiple homogeneously enhancing irregular masses and foci centered in the 8-9 o'clock position with associated architectural distortion. Clip artifact is seen within one of the two largest masses which measures 2.0 x 1.8 x 1.8 cm (AP x TV x CC). Another adjacent contiguous mass seen immediately anterior and medial to this mass which measures 2.1 x 2.0 x 1.5 cm (AP x TV x CC). The entire extent of the masses, including the largest mass, spans 5.3 x 4.9 x 3.7 cm (AP x TV x CC).Left Breast: No abnormal enhancement is seen.Axilla: There are mildly enlarged right axillary lymph nodes, asymmetric when compared to left axilla. Clip artifact is seen along the anterior aspect of the disease positive lymph node which measures up to 2.0 cm (CC). No abnormal lymph nodes are identified in the left axillary region.
(1) Multiple enhancing irregular masses centered in the right lower outer quadrant , the largest of which represents the known biopsy-proven malignancy. The entire extent of abnormal enhancement measures 5.3 x 4.9 x 3.7 cm (AP x TV x CC).(2) Asymmetrically enlarged right axillary lymph nodes as described with the biopsy-proven metastatic lymph node measuring up to 2.0 cm.(3) No MRI evidence for malignancy in the left breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.