Ms. Cordova is a 65-year-old woman with biopsy-proven right breast invasive ductal carcinoma. She presents today for MR imaging for further evaluation. There is scattered fibroglandular tissuein both breasts. Mild parenchymal enhancement is noted bilaterally.RIGHT BREAST: In the right upper outer breast, anterior depth, there is a spiculated enhancing mass identified measuring approximately 1.8 x 1.7 x 2.2 cm (AP x ML x SI). Susceptibility artifact from biopsy marker clip is seen centrally within this lesion, compatible with biopsy-proven malignancy. Seen infero-posteriorly are two additional enhancing lesions, suspected to be adjacent satellite lesions. Total span of abnormal enhancement (index lesion + two adjacent satellite lesions) measures approximately 2.7 x 1.8 x 2.3 cm. In the right lower inner breast (approximately 3 cm infero-postero-medial to the index malignancy), is a linear area of clumped non-mass enhancement measuring approximately 1.6 cm in total dimension.LEFT BREAST: Few scattered enhancing foci are seen in the left breast, none of which are more suspicious than the rest. There is no abnormal enhancement in the left breast. No abnormal axillary lymph nodes are identified in either axillary region.
(1) Biopsy proven malignancy of the right breast with two adjacent satellite lesions. Total span of abnormal enhancement measures approximately 2.7 cm in the AP dimension. (2) 1.6 cm linear area of clumped non-mass enhancement in the right lower inner breast. An MR-guided biopsy with clip placement is recommended for further evaluation. (3) No MRI evidence of malignancy in the left breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.