Ms. Dazzena is a 59-year-old female with biopsy-proven right breast cancer and disease positive lymph node. She presents today for staging. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.Spanning the entire right superior breast is an extensive area of clumped nonmass enhancement measuring approximately 4.7 x 8.2 x 3.9 cm (AP x ML x SI). Within this region of clumped non-mass enhancement are three discrete irregular enhancing masses, which correspond to the masses identified on recent ultrasound exam in the right breast 1:00, 3:00 and 9:00 radians respectively. Susceptibility artifact from biopsy marker clip is identified in the medial aspect of this clumped nonmass enhancement (adjacent to the right 3:00 radian mass), compatible with biopsy-proven malignancy. In addition, there is diffuse skin thickening present about the entire right breast, measuring up to 8 mm in thickness.There is no abnormal MR enhancement identified in the left breast.There are multiple enlarged right axillary lymph nodes identified, the largest of which measures approximately 1.9 cm. One of these enlarged axillary lymph nodes has susceptibility artifact from a biopsy marker clip, compatible with recently biopsy proven lymph node. There are no abnormal axillary lymph nodes in the left axillary region.
(1) Multicentric biopsy proven malignancy of the right breast with disease positive lymph node(2) No MR evidence of malignancy in the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.