57 year old with newly diagnosed left breast DCIS and dense breasts. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally, somewhat of a limitation.In the left lower central breast, there is non-mass enhancement with adjacent foci of enhancement greater than the extent of calcifications on mammography. This is located primarily lateral to the biopsy site/artifact from the biopsy clip. Mild enhancement is noted around the biopsy site. Inclusive of the biopsy site, the area measures 3.5 x 2.3 x 2.9 cm (AP x LM x oblique CC). In the right outer breast near 9:00, an oval enhancing mass measuring 1.4 x 0.6 x 0.7 cm is present. This has predominately high T2 signal, typically benign persistent enhancement and may represent a fibroadenoma. No abnormal lymph nodes are identified in either axillary region.A hiatal hernia is noted.
1. Area of suspicious enhancement in the left inferior breast measuring up to 3.5 cm located primarily just lateral to the biopsy site changes.2. 1.4 cm mass in the right outer breast is probably benign. An MRI directed ultrasound is recommended. As long as the ultrasound finding is concordant with a benign mass, imaging follow up in 6 months would be appropriate. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.