51 year old with biopsy proven right and left breast cancers There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.Strong motion artifacts are seen in the subtraction images, limiting the quality of the study.In the left breast, there are two irregularly shaped masses located back to back in the posterior upper outer quadrant, measuring 18 x 20 x 12 and 20 x 18 x 19 mm (all measurements: AP x LR x CC), consistent with biopsy proven cancer. Clip artifact is seen within both masses. In addition, there is a spiculated mass at left retroareolar region abutting the retracted nipple, measuring 18 x 13 x 21 mm, and there are multiple enhancing small masses and foci in the left upper outer quadrant. A segmental non-mass enhancement in the left upper outer quadrant is encompassing those masses and foci. Overall size of the lesions is 115 x 34 x 58 mm.In the right breast, a metallic artifact from a marker clip placed at the site of proven malignancy is identified at posterior 10 o'clock position. No abnormal enhancement is present around the clip or elsewhere in the right breast. No abnormal lymph nodes are identified in either axillary region.
1. Limited study due to strong motion artifacts.2. Extensive non-mass enhancement with multiple masses and foci, including biopsy proven malignancy, in the left upper outer breast.3. No abnormal enhancement at the site of proven malignancy in the right breast.4. No abnormal lymph nodes in either axillary region.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.