Ms. Trivunovic is a 72 year old female with recent biopsy-proven malignancy of the left upper outer breast. She presents for MR evaluation. There is scattered fibroglandular tissue in both breasts. Mild background parenchymal enhancement is noted bilaterally.LEFT BREAST: In the left upper outer breast, posterior depth, there is an irregular, peripherally enhancing mass identified measuring 3.6 x 4.0 x 3.8 cm (AP x ML x SI). Susceptibility artifact from biopsy marker clip is seen within the central aspect of this necrotic mass, compatible with biopsy-proven malignancy. Extending anteromedially from this index malignancy is an area of nonmass enhancement. Total span of abnormal enhancement (index malignancy + nonmass enhancement) measures approximately 6.2 cm in the oblique AP dimension.There is no additional abnormal enhancement seen in the left breast.RIGHT BREAST:There is no abnormal enhancement seen in the right breast.AXILLA:A biopsy marker clip is seen within a left axillary lymph node, which was proven to be a benign lymph node. No abnormal axillary lymph nodes are identified in the right axillary region.OTHERS:Note is made of a small hiatal hernia and subcentimeter hepatic cyst.
(1) Biopsy-proven malignancy + additional nonmass enhancement extending anteromedially from the index malignancy measures approximately 6.2 cm in maximal dimension in the left breast. Clip is in appropriate position.(2) No MRI evidence of malignancy in the right breast. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.