61-year-old female with recently diagnosed left 1 o'clock breast cancer and metastatic axillary lymph node. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.There are bilateral saline breast implants.LEFT BREAST: In the left breast, 2-3 o'clock position there is a large irregular mass with irregular margin and heterogeneous enhancement that measures 3.4 x 2.6 x 5.4 cm and correlates with the biopsy-proven breast cancer. This mass measures 3.4 x 2.6 x 5.4 cm (AP x transverse x CC). Superolateral to the index mass, there are two additional smaller masses, measuring 1.1 x 1.2 x 1.3 cm (AP x transverse x CC) and 0.5 x 0.7 x 0.5 cm (AP x transverse x cC). There is extensive non-Mass enhancement extending anterior and posterior to the index mass. Total extent of non-mass enhancement and the three masses measures 9 x 3 x 7.5 cm (AP x transverse x CC). Non mass enhancement extends to the nipple, measuring 5 mm from the nipple. Non mass enhancement and index mass abuts and cause medial displacement of the saline implant. There is overlying skin thickening in the left upper outer quadrant.Four abnormal lymph nodes are identified in the left axillary region. The largest measures 2.1 x 2.0 x 2.6 cm.RIGHT BREAST:No abnormal enhancement is seen in the right breast. No abnormal lymph nodes are identified in the right axillary region.
1.Multicentric left breast cancer more extensive than seen on mammogram. Large left 2 to 3 o'clock position irregular mass corresponds with biopsy proven breast cancer. Superolateral two additional smaller masses also correlate with additional masses seen on outside ultrasound. Extensive non-mass enhancement extends anterior and posterior to the index mass.2.Four abnormal left axillary lymph nodes.3.No abnormal enhancement in the right breast.4.No abnormal lymph nodes in the right axilla. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.