41 year old with biopsy proven left breast cancer (2 sites) presents for staging MRI. There is heterogeneous amount of fibroglandular tissue in both breasts.Minimal parenchymal enhancement is noted bilaterally.There is an irregularly shaped enhancing mass, measuring 32 x 24 x 22 mm (AP x LR x CC) with clip artifact at posterior aspect and anterior-lateral aspect, in the left breast at posterior 12 - 1 o'clock position. This is the proven IDC, which was visualized as two masses on ultrasound, but they appear connected each other on MRI. Immediately anterior to the proven cancer, there is another irregularly shaped highly suspicious mass, measuring 27 x 23 x 19 mm. Additionally, there is a suspicious enhancing mass at anterior 12 o'clock position, measuring 11 x 16 x 15 mm. And there are multiple enhancing foci, at retroareolar region, anterior upper inner and upper outer region and middle 6 o'clock position. Those foci are all suspicious for malignancy. Overall extent of these lesions is 83 x 59 x 74 mm.There are at least two left axillary lymph nodes with possible cortical thickening. No abnormal enhancement is seen in right breast. No abnormal lymph nodes are identified in right axillary region.
1. Biopsy proven left breast cancer. MRI demonstrated multicentric disease in the left breast.2. Two possible abnormal left axillary lymph nodes.3. No MRI evidence of malignancy in the right breast or right axillaBIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.