Ms. Woodward is a 43 year old female with a personal history of Li Fraumeni syndrome. She is status post bilateral nipple sparing mastectomy. Evaluate for residual breast tissue. Patient is status post bilateral nipple sparing mastectomy with bilateral implant-based reconstruction. There is no residual breast tissue bilaterally. The left reconstructed breast demonstrates moderate skin thickening and parenchymal edema. In addition, there are two linear enhancing areas identified in the left lower inner breast, that measure 1.0 and 1.5 cm respectively. These enhancing areas abut against the implant. There is no abnormal enhancement in the right reconstructed breast. No abnormal lymph nodes are identified in either axillary or internal mammary region.
(1) No residual breast tissue identified bilaterally.(2) Two linear enhancing lesions in the left lower inner breast along with moderate skin thickening/parenchymal edema. Based on the patient's EMR, a prior MRI was obtained in 2014. Recommend submission of this MRI to evaluate for stability of these findings. If not available, then an MR-directed ultrasound should be performed of the left lower inner breast along with clinical correlation of patient's medical records to clarify the etiology behind the MR findings. (3) No MRI evidence for malignancy in the right reconstructed breast.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.