A patient submitted outside study for review. Submitted for review are breast MRI (7/14/16) performed at outside institution. For comparison, mammograms and ultrasound (7/14/16) are available. Breast MRI was performed with a protocol outlined in the outside report.There is a large area of segmental non-mass enhancement at upper inner and lower inner quadrant of the left breast measuring 55 x 49 x 60 mm (AP x LR x CC). This non-mass enhancement likely corresponds to the proven malignancy. An enlarged lymph node (16 mm) is present at left axilla with a marker clip inside. A metallic artifact from the marker clip is present at anterior lower outer quadrant in the right breast without suspicious enhancement. The marker clip likely corresponds to the site of biopsy-proven malignant lesion. A few borderline enlarged lymph nodes are seen in the right axilla.
1. Large segmental non-mass enhancement in the right upper - lower inner quadrant. 2. A marker clip artifact in the right anterior lower outer quadrant, corresponding to the recent biopsy site.3. Biopsy proven metastatic lymph node in the left axilla with a marker clip4. A few borderline right axillary lymph nodescomments: Outside radiology report mentions that there is a separate focal non-mass enhancement in the left breast at inferolateral to the primary non-mass enhancement, I believe these two non-mass enhancements are contiguous. Also, outside radiology report mentions about an irregular region of enhancement at central inner portion in the right breast, I think this is not a real lesion.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.