36 year old status post left breast stereotactic biopsy showed ALH and breast calcifications, Gail score at 5 years is 2.3%, lifetime risk in 35.5%. MRI requested for screening There is heterogeneous amount of fibroglandular tissue in both breasts. Few subcentimeter cysts noted in both breasts. Marked parenchymal enhancement is noted bilaterally limiting the sensitivity of MRI.Right Breast: Clip artifact identified in the right lower inner quadrant without adjacent abnormal enhancement. Left breast: Clip artifact identified in the upper outer quadrant posterior depth without abnormal enhancement adjacent to it. Clip placed at the time of benign biopsy at 6:00 position is difficult to identify on MRI but no abnormal enhancement is seen at 6:00 position. Benign oval slowly enhancing mass measuring 14 x 7 x 12 mm (AP x ML X CC) in the central posterior breast with a sonographic correlate (dated 8/12/16) most likely represents a benign fibroadenoma. Similar morphology mass measuring 5 x 5 x 3 mm (AP x ML X CC) is noted at 1:00 position, mid depth, most likely representing a benign fibroadenoma. No abnormal enhancement is seen in either breast. No abnormal axillary lymph nodes are identified in either axillary region.
Limited evaluation due to marked parenchymal enhancement. Given these limitations, no MRI evidence for malignancy. Benign morphology masses in the left breast most likely represent benign fibroadenomas. Annual surveillance with MRI should be considered given the high risk of the patient based on the Gail score. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram.