69-year-old female presents with biopsy proven right breast carcinoma (two sites), locally advanced to lymph nodes. There is scattered fibroglandular tissue with mild background parenchymal enhancement noted bilaterally.In the far posterior slightly lower outer left breast, there is a 3.4 x 3.3 x 3.1 cm circumscribed enhancing mass which contained susceptibility artifact from biopsy clip, compatible with the patients known malignancy at the 9 o'clock position. This resides approximately 0 .4 cm anterior to the pectoralis muscle. A second mass is present within the central slightly upper outer right breast measuring 1.4 x 1.0 x 1.2 cm, corresponding to the patient's known malignancy at the 10 o'clock position. Non-mass enhancement is present extending anterior and lateral to the masses, spanning 7.8 cm AP. Total AP extent of enhancement inclusive of masses and non-mass enhancement is 11.4 cm.Multiple prominent right axillary lymph nodes are present. One node contains a Hydromark clip from prior biopsy. Of note, prominent nodes are appreciated at the lateral border of the pectoralis muscle. No areas of abnormal enhancement are present within the left breast. No enlarged lymph nodes are present within the left axilla.
1. Two enhancing masses within the upper outer right breast, compatible with the patient's known malignancy. Non-mass enhancement is noted extending anterior and lateral the the masses. Total extent of enhancement in the right breast is 11.4 cm AP. 2. Multiple prominent right axillary lymph nodes, one of which contains a biopsy clip.3. No MRI evidence of malignancy in the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.