46-year-old female with known DCIS in the left breast presents for breast MRI. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.There is a susceptibility artifact in the left breast at 1:00 position, corresponding to a marker clip from recent biopsy of DCIS. There is a small focal non-mass enhancement around this clip, measuring 6 x 6 x 5 mm (AP x LR x CC). Size of this area of enhancement is smaller than that of the distribution of pleomorphic calcifications on mammogram.There are no other suspicious enhancing lesions elsewhere in the left breast.No abnormal enhancement is seen in right breast. No abnormal lymph nodes are identified in either axillary region.
1. Small focal non-mass enhancement around the marker clip in the left breast at 1:00 position, corresponding to the biopsy-proven DCIS. Because the size of non-mass enhancement is smaller than that of pleomorphic calcifications on mammogram, bracketed wire localization with mammographic guidance is recommended, if conservation surgery is planned.2. No MRI evidence for malignancy in the right breast or either axilla.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.