58 year old with highly suspicious mass in the right breast at posterior upper outer quadrant with segmental pleomorphic calcifications extending anteriorly. There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.RIGHT BREAST:There was an irregularly shaped, heterogeneously enhancing mass at posterior 10:00 position, measuring 28 x 23 x 24 mm (AP x LR x CC). There is a thin fat plane between this mass and pectoralis muscle on T2 weighted images, and there is no pectoral enhancement, suggesting no invasion into the muscle. Segmental non mass enhancement extends from the mass toward the nipple at upper outer quadrant, measuring 51 x 13 x 17 mm. Overall measurement including mass and non mass enhancement is 73 x 23 x 28 mm.LEFT BREAST:No abnormal enhancement is seen in left breast. AXILLAE:No abnormal lymph nodes are identified in either axillary region.
1. Highly suspicious mass with non mass enhancement in the right upper outer quadrant, posterior to anterior aspect. Although the mass is located immediately anterior to the pectoralis muscle, there is no definite evidence for invasion into the muscle.2. No MR evidence for malignancy in the left breast.3. No abnormal lymph nodes in either axilla.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: T - Take Appropriate Action - No Letter.