42 years old who is status post stereotactic biopsy of right breast calcifications with pathology result of atypical ductal hyperplasia presents for research MRI. There is scattered fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.A marker clip from recent stereotactic biopsy is identified at posterior upper outer quadrant in the right breast.There is a regional non-mass enhancement around the marker clip, measuring 24 x 21 x 30 mm (AP x LR x CC).In the left breast, there is an enhancing lobulated mass, measuring 7 x 7 x 13 mm, at anterior 3 o'clock position.Several small patchy enhancing areas are present in both breast. No abnormal axillary lymph nodes are identified in either axillary region.
1. Regional non-mass enhancement at the site of recent stereotactic biopsy. Presence of DCIS cannot be excluded. Excisional biopsy should be considered. 2. Enhancing mass at anterior 3 o'clock position in the left breast. MR-directed ultrasound study is recommended. If no sonographic correlation is detected, MR guided biopsy should be considered. 3. Several small patchy enhancing areas in both breast, for which follow up MRI is recommended in 6 months for stability.4. No abnormal axillary lymph nodes in either axillary region. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.