53 year old with high risk lesion (papilloma with atypia and ADH) in the left breast found on recent US guided biopsy (1/27/15), presents for research MRI. There is scattered fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.There is a lobulated enhancing mass with internal clip artifact at posterior 6 o'clock position, measuring 12 x 12 x 7 mm (AP x LR x CC) in the left breast. This is the high risk lesion which was biopsied recently.There is an additional enhancing lesion, which is an irregularly shaped mass measuring 11 x 11 x 11 mm, at anterior 1 o'clock position in the left breast.No abnormal enhancement is seen in right breast. No abnormal axillary lymph nodes are identified in either axillary region.
1. The biopsied high risk lesion in the left breast shows mass-like enhancement at posterior 6 o'clock position2. Additional enhancing mass at at anterior 1 o'clock position in the left breast. MR directed ultrasound and possible biopsy is recommended. If sonographic correlation is not obtained, MR guided biopsy is recommended.3. No MRI evidence for malignancy in the right breast.4. No abnormal axillary lymph nodes in either axillary region.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.