History of left lumpectomy and sentinal node biopsy in May 2014 present for screening MRI. She is also status post neoadjuvant chemotherapy and adjuvant XRT. There is scattered fibroglandular tissue in both breasts. A few small cysts are scattered in the right breast. Marked parenchymal enhancement is noted in the right breast and minimal enhancement is present in the left breast. This limits the sensitivity of this exam in the right breast.No suspicious focal enhancement is seen in either breast. A focus of enhancement in the anterior depth of the left medial breast is stable. No abnormal lymph nodes are identified in either axillary region.
Significantly asymmetric breast enhancement, right breast much greater than left. The right breast enhancement is much greater than on prior MRIs. The asymmetry is most likely to due to the effect of radiation on the left breast which has in this case decreased the background enhancement on that side. Presuming this 35 year old is having normal menstrual cycles, future MRI follow up exams should be performed at the optimal time of her menstrual cycle (days 7-10) to minimize the effect of background enhancement.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Routine Diagnostic Mammogram.