31 year old with BRCA mutation, screening MRI. A patient submitted outside study for review. Submitted for review is a breast MRI performed at Parkview Outpatient Service Center on 6/6/2016. For comparison, a breast MRI from 4/30/2015 also performed at Parkview Outpatient Service Center is available, this exam was performed with the patient was postpartum and is limited due to postpartum and lactation changes. Outside hospital MRI pre and post contrast images were processed by DynaCad for interpretation.There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.There is a 5 x 4 x 7 mm enhancing focus in the right breast at the 12:00 position with a thin septation which most likely represents a benign fibroadenoma unchanged compared to the prior MRI. A benign intramammary lymph node is identified in the right breast at the 10:00 position and has a T2 and STIR correlate. Small enhancing foci in both breasts are noted, none of which are uniquely enhancing. No abnormal axillary lymph nodes are identified in either axillary region. No abnormal enhancement noted in the left breast.
1.No MRI evidence for malignancy. 2.Benign morphology stable lesion in the 12:00 position in the right breast most likely a fibroadenoma for which no further intervention is recommended given its stability and benign features. Ultrasound may be performed for confirmation but if no definite correlate is found, annual screening mammogram and MRI is recommended.3.Benign intramammary lymph node in the right breast at the 10:00 position.BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter.