Ms. Caywood is a 37 year old female with a personal history of metastatic breast cancer and right modified radical mastectomy in 2013. She has recently been diagnosed with left breast IDC, grade 2 at two sites (9:00 and 10:00 locations). Patient is status post right modified radical mastectomy. There is extreme amount of fibroglandular tissue in the left breast. Moderate background parenchymal enhancement is noted, which limits the sensitivity of this examination.In the left medial breast, there is extensive clumped linear nonmass enhancement identified measuring approximately 6.5 x 4.2 x 7.1 cm (AP x ML x SI). Susceptibility artifact from two biopsy marker clips (hydromark clip and ribbon clip) are identified. Based on the mammogram, these clips are separated by approximately 2.5 cm in the SI dimension and 1.8 cm in the ML dimension. No abnormal lymph nodes are identified in either axillary or internal mammary region.Multiple T2-hyperintense hepatic lesions are identified, some of which faintly enhance. These likely correspond to the known hepatic metastases seen on multiple prior CT examinations. Known osseous metastases are not well seen on this MRI exam.
(1) Extensive clumped linear nonmass enhancement in the left medial breast spanning approximately 6.5 cm in AP dimension, corresponding to the recent biopsy results of IDC grade 2 in two sites.(2) Status post right modified mastectomy.(3) Incompletely evaluated known hepatic and osseous metastases. These are better characterized on recent CT examination performed in September 2016.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.