Ms. Johnican is a 43 year old female with known left breast cancer status post neoadjuvant chemotherapy and disease positive left axillary lymph node. Personal history of benign left breast biopsies for tubular adenoma and fibroadenoma and benign right axillary lymph node biopsy. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.LEFT BREAST: In the left superior breast, at site of known malignancy, there is revisualization of an irregular enhancing mass measuring 2.3 x 1.7 x 1.9 cm (AP x ML x SI), previously measuring 2.1 x 2.3 x 2.1 cm. Biopsy marker clip is located centrally within this malignancy. There is associated minimal skin dimpling seen anteriorly.Biopsy-proven tubular adenoma and biopsy-proven fibroadenoma of the left breast measure 1.5 x 1.0 x 1.2 cm and 0.8 cm respectively, not significantly changed in size and appearance when compared to prior examination.RIGHT BREAST:There is no abnormal enhancement seen in the right breast.AXILLA: There has been an interval decrease in size of previously enlarged left axillary lymph nodes, two of which contain biopsy marker clips. The two biopsied left axillary lymph nodes now measure 1.7 x 0.7 cm and 1.1 x 0.5 cm respectively. Previously enlarged right axillary lymph nodes have also decreased in size when compared to prior examination, the larger one of which contains a Hydromark biopsy clip.
(1) Interval decrease in size of left breast index malignancy and left axillary lymph nodes.(2) No MR evidence of malignancy in the right breast.(3) Stable biopsy-proven tubular adenoma and fibroadenoma of the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.