52-year-old female with biopsy proven locally advanced triple negative right breast carcinoma presents for staging examination. Patient has received one round of chemotherapy. There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.Three enhancing masses are present within the central lateral right breast. The largest mass measures 3.8 x 4.1 x 3.4 cm and demonstrates heterogeneous enhancement. Susceptibility artifact from a biopsy clip is present within this mass. Immediately adjacent to the superior postero-lateral margin of the index lesion is a second heterogeneously enhancing mass measuring 2.2 x 2.6 x 3.0 cm. A third, homogeneously enhancing mass is present along the anteromedial margin of the index lesion measuring 1.0 x 0.9 x 1.0 cm. The most anterior mass resides approximately 1 cm posterior to the nipple. Total area of enhancement in the right breast measures 3.8 x 6.9 x 4.5 cm and extends to the lateral cutaneous surface, mid depth, and to the lateral margin of the nipple. Multiple (at least 4) prominent lymph nodes are present within the right axilla. The largest measures 2.6 cm with effacement of the fatty hilum, and contains susceptibility artifact from a biopsy clip. A 1.9-cm retropectoral lymph node is also present on the right. No abnormal enhancement is seen in the left breast. Multiple normal appearing lymph nodes are present in the left axilla.
1.Three masses within the central lateral right breast as above which abut the cutaneous surface laterally, and extend to the lateral margin of the nipple. Total area of enhancement in the right breast measures 6.9 cm in AP dimension. Biopsy clip is noted within the largest mass.2. At least 4 enlarged right axillary lymph nodes, the largest identified measures 2.6 cm and contains a biopsy clip.3. Enlarged right retropectoral lymph node.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.