Ms. Miller is a 72 year old female with two areas of biopsy proven malignancy in the left breast. She presents for MRI evaluation for staging purposes. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.LEFT BREAST:In the left lateral breast, there are two irregular enhancing masses identified. The anterior mass measures 1.4 x 1.7 x 1.2 cm (AP x ML x SI). Seen immediately anterior to this mass is a 2.8 cm hematoma, of which contains susceptibility artifact from the biopsy marker clip. The posterior mass measures 1.3 x 1.5 x 1.3 cm, which contains a centrally located biopsy marker clip. The two masses span approximately 4.3 cm in the AP oblique dimension.There is no additional abnormal enhancement seen in the left breast. RIGHT BREAST:There is no abnormal enhancement seen in the right breast. AXILLA: There is a prominent left axillary lymph node present, which measures approximately 2.1 cm in maximal dimension. No abnormal axillary lymph nodes are identified in the right axillary region.
(1) Two biopsy proven malignancies in the left lateral breast, spanning approximately 4.3 cm in the AP oblique dimension. Of note, the biopsy clip for the anterior mass is located slightly anteriorly within an adjacent hematoma.(2) Prominent left axillary lymph node. MR directed ultrasound is recommended for further evaluation.(3) No MRI evidence of malignancy in the right breast. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.