44 year old with history of biopsy proven right breast cancer. Calcifications seen extending anterior to the proven malignancy were noted on mammography. The patient is part of the fast research protocol. There is heterogeneous amount of fibroglandular tissue in both breasts.Marked parenchymal enhancement is noted bilaterally. The ultrafast images show less background enhancement. There are multiple abnormal enhancing masses the right breast. This includes the biopsy proven index cancer in the right inner breast that measures 1.6 x 2.1 x 1.6 cm. Extending predominately in a segmental distribution towards the nipple are multiple subcentimeter enhancing masses which are suspicious for satellite lesions. The largest of these measures 9 mm. An additional round enhancing mass just lateral to the right nipple measures 5 mm. This may represent an additional site of malignancy or potentially a benign lesion such as a papilloma. The distance between the index lesion and the largest satellite lesion is 5.8 cm. The distance between the index lesion and the lateral anterior mass is 7.7-cm. There is extensive fluid filling dilated ducts in the right outer breast. However, there is no distinct suspicious enhancement around these ducts. The appearance may relate to a prior ductogram. No abnormal enhancement is seen in the left breast. No abnormal lymph nodes are identified in either axillary region.
1. Multiple enhancing right breast masses masses, predominantly in the right inner breast, including the biopsy proven malignancy. If breast conservation is being considered, then MRI directed ultrasound to assess the additional masses is recommended.2. No MRI evidence for malignancy in the left breast. 3. No suspicious axillary lymph node. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.