25-year-old status post excisional biopsy of left breast mass with pathology revealing DCIS and positive margins presents for bilateral staging breast MRI. There is extreme amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally. Bilateral saline implants are intact.Left breast: In the upper inner breast near the 11:00 position, there is enhancement consisting of three adjacent areas of focal and non-mass enhancement together measuring 1.7 x 1.6 x 1.9 cm, suspicious for malignancy. This approaches to within 4 mm of the skin surface. There is some distortion of the adjacent breast parenchyma likely related to post excisional biopsy changes near this site of enhancement. Additionally, in the left retroareolar region, there is a round enhancing focus measuring 4 mm, which enhances similarly to the area mentioned above. This focus is 1.0 cm from the nipple. Patchy areas of enhancement are noted elsewhere throughout the breast, likely related to background parenchymal enhancement. There is no abnormal enhancement involving the nipple itself or the skin of the left breast.Right breast: Patchy areas of enhancement are noted throughout the breast, likely related to background parenchymal enhancement. There is no discretely enhancing mass, or suspicious focus of enhancement. Right nipple enhancement is symmetric with respect to the left. No abnormal lymph nodes are identified in either axillary region.
Areas of suspicious enhancement in the left breast, one in the superior 11:00 position near the site of excisional biopsy measuring up to 1.9 cm and another in the retroareolar region measuring 4 mm. No suspicious enhancement in the right breast or either axilla. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.