Breast cancer. There is a subcentimeter area of high T2 signal without associated enhancement, susceptibility effect, or restricted diffusion in the left insular subcortical white matter. There are a few other punctate foci of T2 hyperintensity in the cerebral white matter. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
A subcentimeter nonenhancing lesion in the left insula and other smaller cerebral white matter lesions are nonspecific, but may represent chronic small vessel ischemic disease, without convincing evidence of intracranial metastases otherwise.