Ms. Kerulis is a 37 year old female with biopsy proven malignancy of the left breast and metastatic left axillary lymph node. She is currently on the I-SPY 2 research protocol. There is scattered fibroglandular tissue in both breasts. Mild background parenchymal enhancement is noted bilaterally.LEFT BREAST: In the left upper outer breast, there is an irregular enhancing mass identified measuring approximately 7.4 x 3.9 x 6.0 cm (AP x ML x SI). Susceptibility artifact from biopsy marker clip is seen within the central aspect of this lesion, compatible with biopsy-proven malignancy. There is no additional abnormal enhancement identified in the left breast.At least 4 abnormal lymph nodes are identified in the left axilla, the largest of which measures approximately 3.6 cm. Susceptibility artifact from biopsy marker clip is seen within the peripheral aspect of this lymph node, compatible with biopsy-proven metastatic left axillary lymph node.RIGHT BREAST: In the right lower inner breast, there is an oval subcentimeter enhancing mass with internal fat signal intensity identified. This corresponds to the mammographically seen benign morphology mass, and is compatible with a benign intramammary lymph node. No abnormal enhancement is seen in the right breast.No abnormal axillary lymph nodes are identified in the right axillary region.
(1) Biopsy proven malignancy of the left breast with metastatic left axillary lymph node.(2) No MRI evidence of malignancy in the right breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.