65-year-old female with bilateral breast masses on recent mammographic and ultrasound examination presents for Alan Penn research MRI. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.Left breast:Note is made of an 6 x 6 x 8 mm (AP x TR x CC) heterogeneously enhancing irregular mass at the 2 o'clock position of the left breast which demonstrates washout kinetics on dynamic contrast-enhanced images. This mass corresponds to the suspicious mass detected on the recent mammogram and ultrasound study.Additionally note is made of a 9 x 6 x 8 mm (AP x TR x CC) spiculated enhancing mass at the 5 o'clock position of the left breast at mid depth which demonstrates washout kinetics on dynamic contrast enhanced images. This mass is mammographically occult.There one abnormal left axillary lymph nodes measuring 14 x 9 x 12 mm (AP x TR x CC).Right breast:Note is made of a 10 x 9 mm nonenhancing lobulated mass at the 6 o'clock position of the right breast which demonstrates decreased signal abnormality on T2-weighted images, consistent with a benign etiology. This benign mass corresponds to the mass detected on the recent mammographic and ultrasound study. There is no evidence of right axillary lymphadenopathy.
1. Two suspicious masses in the left breast, one of which corresponds to findings on recent ultrasound examination, and the other of which is mammographically occult. Both masses were detected on ultrasound later today and ultrasound guided biopsy was performed.2. One abnormal left axillary lymph node. Ultrasound guided biopsy was performed later today. 3. Benign morphology non enhancing mass at the 6 o'clock position of the right breast corresponding to the findings on recent mammographic and ultrasound examination. Because this is highly likely benign, ultrasound guided biopsy was NOT performed.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.