Ms. Farmer is a 75-year-old female with screen-detected calcifications in the right breast for which stereotactic biopsy is recommended. Patient now presents for MRI for further evaluation. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.In the right central breast, mid depth, there is a segmental distribution of linear nonmass enhancement is identified measuring 2.3 x 0.8 x 1.0 cm (AP x ML x SI). This corresponds to the mammographically detected calcifications for which stereotactic biopsy will be performed.In addition, in the right medial breast, periareolar region, there is a 0.5 cm focus of enhancement.In the left medial breast, periareolar region, there is a 1.1 cm segment of linear nonmass enhancement identified. No abnormal axillary lymph nodes are identified in either axillary region.
(1) 2.3 cm span of linear nonmass enhancement in the right central breast, corresponding to the mammographically detected calcifications. A stereotactic biopsy will be performed later today.(2) 0.5 cm focus of enhancement in the right medial breast. An MR directed ultrasound with possible biopsy will be performed if sonographic correlate is identified.(3) 1.1 cm span of linear nonmass enhancement in the left medial breast. An MR directed ultrasound with possible biopsy will be performed if sonographic correlate is identified.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. 