Ms. Skoog is a 54 year old female who initially presented with a palpable thickening/tenderness in the left breast with subtle sonographic findings. She presents for same day MR evaluation and US guided biopsy of this area in the left breast. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild background parenchymal enhancement is noted bilaterally.LEFT BREAST:Spanning the entire left upper outer breast, there is diffuse abnormal enhancement seen measuring approximately 6.6 x 4.0 x 6.9 cm (AP x ML x SI). The measurement in the AP oblique plane is approximately 10.3 cm. The enhancement extends from the pectoralis muscle into the nipple itself. Although the enhancement abuts against the pectoralis muscle, a discrete fat plane is seen and the pectoralis muscle is of normal contour and enhancement pattern. RIGHT BREAST: No abnormal enhancement is seen in the right breast. AXILLA:No abnormal axillary lymph nodes are identified in either axillary region.
(1) 10.3 cm span of diffuse abnormal enhancement seen in the left upper outer breast, spanning from the pectoralis muscle to the nipple. An US guided biopsy will be performed later day. (2) No MRI evidence of malignancy in the right breast. BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: X - No Letter.