Ms. Austin is a 57-year-old female with multifocal invasive cancer of the right breast currently undergoing neoadjuvant chemotherapy. Personal history of left breast mastectomy in 1998. The patient is status post left mastectomy and bilateral retropectoral silicone implants. There is scattered fibroglandular tissue in the right breast. Mild parenchymal enhancement is noted in the right breast.Bilateral silicone implants appear intact.RIGHT BREAST: In the right breast, there has been significant decrease in size of the two biopsy proven malignancies. In the right breast 3:00 location, the irregular enhancing mass now measures 1.6 x 2.8 x 2.0 cm (all measurements: AP x LR x CC), compared to 2.3 x 3.2 x 2.7 cm. In the right breast 9:00 location, the irregular enhancing mass now measures 0.7 x 0.9 x 0.9 cm, compared to 1.7 x 2.1 x 2.1 cm.In addition, the previously noted extensive nonmass enhancement encompassing these 2 masses now measures approximately 3.5 x 5.8 x 2.8 cm, compared to 4.8 x 7.0 x 6.9 cm.LEFT RECONSTRUCTED BREAST: No abnormal enhancement is seen in the left reconstructed breast. No abnormal axillary lymph nodes are identified in either axillary region.
(1) Interval decrease in size of known right multicentric cancer.(2) No MR evidence for malignancy in the left postmastectomy breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.