49 year old female with biopsy proven cancer in right breast presents for staging. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate nodular parenchymal enhancement is noted bilaterally.RIGHT BREAST:Irregular, heterogeneously enhancing mass with spiculated margins noted in the right breast 10:00 position that measures 1.8 x 1.4 x 1.6 cm (AP x ML x CC) and a clip artifact is identified within it. Located 1 cm, anterior and medial to this lesion is a second irregular enhancing mass with spiculated margin at 12:30 position that measures 1 x 0.8 x 0.8 cm. The total extent is 2.5 x 4.1 cm. Located anterior to the biopsy proven mass is a lobulated, circumscribed, hematoma that measures 2.6 x 1.3 centimeters. LEFT BREAST: Oval enhancing mass left breast two o'clock position measures 0.7 x 0.6 x 0.6 cm that needs further evaluation with MR directed ultrasound.No abnormal lymph nodes are identified in either axillary region.
1. Biopsy proven cancer in the right breast 10 o'clock position with a second suspicious mass at 12:30 o'clock position, located 1 cm anterior and slightly medial to it. MR directed ultrasound and biopsy is recommended for this mass. If lesion not seen on ultrasound, MR guided biopsy is recommended.2. Oval 7-mm enhancing mass left breast two o'clock position, needs further evaluation with MR directed ultrasound. If lesion not seen on ultrasound, MR guided biopsy is recommended3. Normal axillary lymph nodes noted bilaterally. BIRADS: 6 - Known cancer.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.