47-year-old woman with bilateral breast masses presents for further evaluation. Patient is in rolled in the Alan Penn Research Study. There is large amount of heterogeneous fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.Right breast:In the upper inner quadrant of the right breast, near the 2:00 position, posterior depth, there is an oval enhancing mass measuring 1.2 x 0.8 x 0.6 cm. This mass demonstrates progressive enhancement with washout on dynamic evaluation, correlates with the finding on mammogram and ultrasound and is suspicious for malignancy. There is no additional suspicious enhancing mass or focus of enhancement elsewhere within the right breast.Left breast:In the lower central left breast near the 6:00 location, posterior depth, there is an oval enhancing mass measuring 1.5 x 1.2 x 1.2 cm. This mass demonstrates rather than enhancement with washout on dynamic evaluation, correlates with finding on mammogram and ultrasound and is suspicious for malignancy. There is no additional suspicious enhancing mass or focus of enhancement elsewhere in the left breast.No abnormal lymph nodes are identified in either axillary region.
(1) Oval enhancing mass at the right 2:00 position measuring up to 1.2 cm is suspicious for malignancy. The patient underwent an ultrasound guided biopsy of this mass after the MRI. Pathology results are pending.(2) Oval enhancing mass at the left 6:00 position measuring up to 1.5 cm is suspicious for malignancy. The patient underwent an ultrasound guided biopsy of this mass after the MRI. Pathology results are pending.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.