Ms. Gagnon is a 59-year-old female with biopsy-proven IDC/DCIS of the right breast, spanning approximately 7.3 cm on prior MRI. She is currently undergoing neoadjuvant chemotherapy. She presents today for repeat MRI to assess for imaging evaluation to treatment response. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.RIGHT BREAST: There has been an interval decrease in size of biopsy-proven heterogeneously enhancing mass in the right upper outer breast, posterior depth, now measuring 2.1 x 1.5 x 1.8 cm, previously measuring 2.8 x 2.3 x 2.4 cm (AP x LR x CC). There continues to be a thin fat plane between thismass and pectoralis muscle on T2 weighted images, and there is no pectoral enhancement, suggesting no invasion into the muscle. There continues to be segmental nonmass enhancement extending anteriorly from the mass in the right upper outer breast, measuring approximately 5.0 x 1.6 cm, previously measuring 5.1 x 1.7 cm. However, this non-mass enhancement has decreased in overall enhancement intensity and pattern. Overall measurement including mass and non mass enhancement is 6.6 x 2.3 cm, compared to 7.3 x 2.8 cm.LEFT BREAST:No abnormal enhancement is seen in left breast. AXILLAE:No abnormal lymph nodes are identified in either axillary region.A vascular port overlies the left upper chest wall.
(1) Decreasing size of index malignancy in the right upper outer breast with residual total enhancement measuring 6.6 cm in the AP dimension (compared to 7.3 cm).(2) No MRI evidence of malignancy in the left breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.