38 year old female with biopsy proven invasive ductal carcinoma in the left breast. There are a possible satellite near the index cancer, a questionable enlarged left axillary lymph node, and questionable asymmetries in the right breast on the outside studies. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.LEFT BREAST:There is an enhancing mass at posterior 5:30 position measuring 22 x 19 x 20 mm (AP x LR x CC), which is proven malignancy. Marker clip is present just medial to this mass. There are additional 4 small masses, measuring up to 9 mm, located anteriorly from the index mass. Total AP measurement including most anterior mass and index mass is 4.9 cm. In addition, there is a enhancing mass measuring 11 x 10 x 11 mm at 12:00 position. Distance from this mass to the index mass is approximately 8 cm.There is a lymph node with thickened cortex at left axilla.RIGHT BREAST:No abnormal enhancement is seen in right breast. No abnormal lymph nodes are identified in right axillary region.
1. Biopsy proven cancer in the posterior left 5:30 position with anterior satellites. In addition, an enhancing mass is present at 12:00 position. MR directed ultrasound for the left breast to look for the additional lesions is recommended.2. Suspicious lymph node in the left axilla. MR directed ultrasound is recommended.3. No MRI evidence for malignancy in the right breast or right axilla.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.