Ms. Wesley is a 47-year-old female with known right breast IDC with lobular features/DCIS and a metastatic right axillary lymph node. She presents today for I-SPY research MRI (#4). There is scattered fibroglandular tissue in both breasts. Mild background parenchymal enhancement is noted bilaterally.RIGHT BREAST: There has been slight interval decrease in size of biopsy-proven malignancy in the right retroareolar region now measuring 3.2 x 1.4 x 3.0 cm, previously measuring 3.2 x 2.7 x 3.3 cm (AP x ML x SI). The biopsy-proven malignancy demonstrates less avid enhancement on postcontrast sequences when compared to the prior study. Again seen is a biopsy marker clip located centrally within this malignancy. There continues to be minimal persistent periareolar skin thickening. Multiple benign enhancing masses in the right breast are unchanged. Biopsy-proven metastatic right axillary lymph node now measures 1.5 x 0.9 cm, previously 1.8 x 1.1 cm. Biopsy marker clip is located centrally within this lymph node. No new abnormal enhancement is identified in the right breast. LEFT BREAST:No abnormal enhancement is seen in the left breast. No abnormal axillary lymph nodes are identified in the left axillary region. Vascular port again present in the left medial chest wall.
(1) Slight interval decrease in size and marked decrease in enhancement pattern of patient's known right breast malignancy. Slight interval decrease in size of known metastatic right axillary lymph node.(2) No MRI evidence of malignancy in the left breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.