63-year-old female with newly diagnosed right breast cancer, further evaluation with MRI. There is heterogeneous amount of fibroglandular tissuein both breasts.Mild parenchymal enhancement is noted bilaterally.Right breast: Spiculated enhancing mass with heterogeneous internal enhancement is identified in the right breast 9:00 position measuring 27 x 25 x 31 mm (AP X ML X CC). A clip artifact is identified along the inferior aspect of this mass. Located adjacent and inferior to it is another spiculated enhancing mass at 8:00 position measuring 27 x 22 x 21 mm (AP X ML X CC). Minimal high signal intensity fluid is identified within the ductal system at 9:00 position. Right breast skin thickening with retraction of the nipple is also noted.Multiple enhancing masses are identified extending inferiorly, medially and anteriorly from the index mass at 9:00 position extending from 5:00 position to 9:00 position making the total extent of 57 x 50 x 59 mm (AP X ML X CC). The anterior most enhancing mass abuts the nipple. The medialmost mass at 5:00 position measures 14 x 10 x 11 mm (AP X ML X CC).No other clip artifact identified in any other part of the breast. Patient will obtain a postprocedure mammogram today.Left breast:No abnormal enhancement is seen in left breast. Axillae:Three small size lymph nodes identified in the right axillary region however given that they had suspicious morphology on outside hospital ultrasound, repeat right axillary ultrasound is recommended for further evaluation. No abnormal axillary lymph nodes are identified in left axillary region.
1. Multicentric right breast cancer with clip artifact located along the inferior aspect of the index cancer at 9:00 position. Total extent measures 57 x 50 x 59 mm (AP X ML X CC).Anteriormost satellite abuts the nipple.2. Three small size lymph nodes identified in the right axillary region however given that they had suspicious morphology on outside hospital ultrasound, repeat right axillary ultrasound is recommended for further evaluation. 3. Patient will obtain postprocedure mammogram today. If only one clip is seen within the index mass, additional clips might have to be placed within the anteriormost/medialmost mass to mark the extent of disease.4. No abnormality noted within the left breast or axillary region.BIRADS: 6 - Known cancer.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.