Ms. Bergiel is a 34 year old female with known multifocal right breast cancer. She presents for MRI evaluation after neoadjuvant chemotherapy. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.Susceptibility artifact from the two posterior-most biopsy marker clips are identified. There is no abnormal enhancement seen around these clips or elsewhere in the right breast. Previously seen enhancing masses along with associated non-mass enhancement is no longer present on today's exam.There is no abnormal enhancement seen in the left breast. No abnormal lymph nodes are identified in either axillary or internal mammary region.
(1) Complete imaging response of malignancy in the right breast. If breast conservation therapy is desired, a single wire can be placed targeting the anterior-most clip (rod shaped) and then extend the surgical specimen posteriorly to the pectoralis muscle. (2) No MRI evidence for malignancy in the left breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.