Known left breast cancer, status post index lesion biopsy. There is scattered fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally with numerous scattered foci noted bilaterally. The index malignancy in the left breast near the 11:00 position is well seen as an enhancing mass with internal biopsy clip artifact measuring 2.1 x 1.9 x 2.1 cm. Additionally, projecting anterior and inferior to the proven malignancy, there is extensive nonmass enhancement measuring up to 5.5 x 6.0 cm when the index malignancy is included in measurements. Positionally, the previously noted satellite finding on ultrasound likely resides with the area of non-mass enhancement. Elsewhere in the left breast, there are numerous enhancing foci which appear symmetric when compared to the right side.Two left axillary lymph nodes are mildly asymmetric compared to the right, including a node with mild cortical thickening measuring 5 mm. A non-enhancing high T2 lesion near the skin of the left axilla is compatible with a benign skin cyst. No suspicious enhancement is seen in the right breast. No abnormal axillary lymph nodes are identified in the right axillary region.
Index left breast malignancy measures up to 2.1 cm and is associated with extensive nonmass enhancement, with total measurements up to 6.0 cm. Mildly suspicious axillary lymph nodes also noted. Depending on planned surgical management, ultrasound guided biopsy of the satellite lesion seen on the prior ultrasound and a left axillary lymph node can each be considered. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.