39 year old female with a known left IDC grade 3 presents for I-SPY 2 MRI study (pre-treatment). History of recent benign left breast biopsy at 6:00 position. There is scattered fibroglandular tissue in both breasts.Marked parenchymal enhancement is noted bilaterally.A known cancer is identified at retroareolar region in the left breast as a large enhancing mass, measuring 41 x 45 x 45 mm (AP x LR x CC). The lesion extends into anterior skin and the nipple. 13 mm hematoma is present at middle 6:00 position in the left breast, from recent benign biopsy.Patchy area of strong parenchymal enhancement is heterogeneously seen in both breasts. No abnormal enhancement is seen in right breast. In the left axilla, there are at least 2 abnormally enlarged lymph nodes; the largest lymph node with a marker clip measures 30 x 18 mm (CC x LR). The biopsy result of this lymph node was benign.Mildly enlarged lymph nodes are present in the right axilla; however, none of them appears suspicious.
1. Biopsy proven left breast cancer, extending to the skin and nipple.2. No apparent suspicious lesions in the right breast, although there is strong, heterogeneous parenchymal enhancement. Right breast can be followed in the subsequent MRI studies according to I-SPY protocol. 3. Two enlarged lymph nodes in the left axilla. Recent biopsy of the largest lymph node was benign.4. No abnormal lymph nodes in the right axilla.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.