31 year old with node positive triple negative left breast cancer. There is extreme amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.The known malignancy in the left upper outer breast at posterior depth is seen is an enhancing mass measuring 3.2 x 2.5 x 5.1 cm (AP x LM x CC). It is possible that in the CC dimension, an adjacent satellite lesion is present rather than a contiguous 5.1 cm mass. Additionally, located primarily anteriorly and inferiorly to the index malignancy are additional small masses and foci suspicious for satellite lesions. The largest of these measures about 1 cm. In total the inferior cluster of small masses and foci measures 3.3 x 2.9 x 2.7 cm. A 6 mm satellite mass is adjacent to the posterior/lateral aspect of the index lesion as well. Overall CC extent measures up to 8.8 cm, inclusive of the index cancer and satellite masses. The index mass abuts the pectoralis muscle posteriorly, though no definitive abnormal pectoralis enhancement is appreciated. The biopsy-proven metastatic lymph node with Hydromark biopsy clip artifact measures up to 2.2 cm. A subcentimeter lymph node inferior to the biopsied node is also somewhat suspicious based on it's lack of normal fatty hilum. No suspicious enhancement is seen in the right breast. A few enhancing foci of benign morphology and kinetics are noted. No suspicious right axillary lymph node. Right axillary nodes maintain normal fatty hila.
Biopsy-proven malignancy in the left breast and axilla. Additional small masses and foci in the left breast are suspicious for satellite lesions, with total extent up to nearly 9 cm. MRI directed ultrasound with biopsy of a satellite mass could be performed to define extent of disease. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.