59-year-old female with biopsy proven IDC and DCIS of the right breast, spanning approximately 7.3 cm on the prior MRI dated 12/14/2015 and 6.6 cm on the MRI dated 3/9/2016. Patient is currently undergoing neoadjuvant chemotherapy. She presents today for the repeat MRI to assess the imaging evaluation to treatment response. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.RIGHT BREAST:There has been interval decrease in size and enhancement of the biopsy-proven heterogeneously enhancing mass in the right upper outer breast, far posterior depth, which now measures 0.7 x 0.8 x 1.6 cm (AP x LR x CC), previously measuring 2.1 x 1.5 x 1.8 cm. There continues to be a thin fat plane between this mass and the pectoralis muscle on T2-weighted images.The previously described nonmass enhancement extending anteriorly from the above mass in the right upper outer quadrant has become less conspicuous and decreased in size and enhancement. Of note, this nonmass enhancement corresponded to the linear calcifications on the prior mammogram, which are likely to persist on mammograms. Overall measurement including mass and mild non-mass enhancement is approximately 1.3 x 3 cm, which previously was 6.6 x 2.3 cm on the prior.LEFT BREAST:No abnormal enhancement is seen in the left breast.Axillae:No abnormal lymph nodes are identified in either axillary region.
1. Continued decrease in size and enhancement of the index malignancy in the right upper outer breast with residual enhancement measuring up to 3 cm in the oblique AP dimension (previously 6.6 cm). It is expected that the known extensive calcifications persist on mammography. 2. No MRI evidence of malignancy in the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.