Ms. Balling is a 61-year-old female with biopsy-proven left breast cancer and disease positive lymph nodes status post neoadjuvant chemotherapy. She presents today for MR imaging to evaluate treatment response. There is scattered fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.In the left central breast, there has been an interval decrease in size and overall enhancement pattern of the biopsy-proven malignancy. Residual enhancement consists of scattered enhancing masses/foci spanning approximately 3.9 x 1.7 x 1.7 cm (AP x ML x SI), previously measuring 5.1 x 4.4 cm. Susceptibility artifact from biopsy marker clip is seen within the central aspect of this malignancy. Of note, there is an enhancing intramammary lymph node identified in the left medial breast, which is stable in size and appearance when compared to the prior MRI from 5/2015.In addition, there has been an interval decrease in size of disease positive left axillary lymph node, now measuring 1.8 x 1.9 x 1.9 cm, previously measuring up to 4.1 cm on prior MRI from 5/2015. There is no abnormal enhancement identified in the right breast. No abnormal lymph nodes are identified in the right axillary region.
(1) Interval decrease in size/enhancement of the biopsy-proven malignancy in the left central breast and disease positive left axillary lymph node. Residual disease in the left breast measures approximately 3.9 cm in the AP dimension.(2) No MR evidence of malignancy in the right breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. 