History of left breast DCIS with microinvasion and status post left axillary lymph node biopsy with benign results. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.Within the left breast extending from less than 1 cm anterior to the pectoralis up to the nipple is suspicious nonmass enhancement compatible with the diagnosis of DCIS with microinvasion. The overall span is approximately 13.8 x 7.1 x 5.0 cm. Note is made of a focus of enhancement immediately adjacent to the nipple.Within the right outer breast, a significantly less large but still somewhat suspicious area of nonmass enhancement is seen. This measures approximately 4.9 x 1.2 x 2.9 cm. The appearance is nonspecific, though DCIS is a possibility. Based on the appearance, it is felt to be unlikely that a correlate for this finding would be seen at an MRI directed ultrasound.There are mildly prominent but largely symmetric nodes in each axilla, including the node that contains biopsy clip artifact from the previous benign biopsy.
1. Extensive nonmass enhancement in the left breast correlating with extensive calcifications on mammography and the biopsy results at 2 sites.2. Area of nonmass enhancement in the right outer breast for which MRI guided biopsy is recommended.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.