A patient submitted outside study for review. There is a biopsy proven malignancy in the left breast at the periareolar region. Submitted for review are breast MRI (8/10/16), ultrasound images of both breast (8/16/16) performed at outside institution. For comparison, digital mammographic images (7/25/2016), ultrasound images of left breast (7/25/2016), images from ultrasound guided biopsy of left breast and postprocedural left mammographic images (7/26/2016) are available. BREAST MRI (8/10/16):Breast MRI was performed with a protocol outlined in the outside radiology report.MR images could not be processed on the DynaCAD workstation; therefore, an interpretation was made with axial images on PACS. No reformatted sagittal or coronal images were available.There is scattered fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.There is an enhancing mass at superior aspect of the left retroareolar region, measuring 9 x 8 mm (AP x LR) on axial view, which corresponds to the proven carcinoma. The mass attaches to the skin and is located superior to the nipple. A marker clip is present within the mass.Although there are multiple enhancing foci in both breasts, they are background parenchymal enhancement. None of them are suspicious enough to require MR directed ultrasound or MR guided biopsy.No abnormal enhancement is seen in right breast. No abnormal lymph nodes are identified in either axillary region.ULTRASOUND IMAGES OF BOTH BREAST (8/16/16):Although a hypoechoic structure is captured in each breast, the outside radiology report stated that these findings were non-specific, such as a fat lobule or normal background in real time study.
1. Unifocal carcinoma at superior aspect in the left retroareolar region.2. No abnormal enhancement in right breast. 3. No abnormal lymph nodes are identified in either axillary region.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.