51-year-old with biopsy-proven right breast cancer. There is scattered fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally. There are multiple scattered enhancing foci breasts aside from the lesions described below.The index malignancy in the right upper outer breast is seen with hydromark biopsy clip along its anterior aspect. There is a contiguous tail of enhancing tissue projecting away from the main lesion, towards the pectoralis. Pectoralis muscle enhances normally however. The main portion of the index lesion measures 2.0 x 1.5 x 2.6 cm (AP x LM x CC). Inclusive of the contiguous tail of enhancing tissue the AP measurement is up to 3.5 cm. There is an additional mass in the right breast, near the 2:00 position. This measures 10 x 8 x 9 mm. The kinetic pattern is more suggestive of a benign lesion, however the mass appears somewhat irregular in morphology.Within the left breast, the most enhancing focus measures 5-6 mm, though kinetics are not suspicious. No enhancing masses or suspicious areas of nonmass enhancement elsewhere in the left breast. No abnormal lymph nodes are identified in either axillary region.
1. Index malignancy measures up to 3.5 cm AP inclusive of a contiguous enhancing tail extending posterior from the main portion of the lesion.2. Additional enhancing mass in the medial right breast measuring up to 1.0 cm and should be evaluated with MRI directed ultrasound.3. Left breast 6 mm enhancing area is low suspicion but will also be evaluated on ultrasound. If the left breast focus is negative on ultrasound, then a 12 month MRI follow up should be performed. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.