Ms. Lau is a 32 year old female with known right breast IDC. She presents for MRI imaging evaluation. There is heterogeneous amount of fibroglandular tissue in both breasts. Moderate background parenchymal enhancement is noted bilaterally, which limits the sensitivity of this examination.RIGHT BREAST:Spanning the entire right lower inner breast, there is an irregular enhancing mass identified measuring 3.4 x 1.9 x 3.6 cm (AP times ML times SI). This mass measures 3.7 cm in AP oblique dimension. This corresponds in distribution and location to the mammographically detected calcifications, which span approximately 4.8 cm. Susceptibility artifact from biopsy marker clip is seen within this mass, compatible with biopsy-proven malignancy.LEFT BREAST:There is no abnormal enhancement seen in the left breast. AXILLAE:There is a prominent right axillary lymph node identified with eccentric cortical thickening, measuring approximately 1.4 cm in dimension.There are no abnormal axillary lymph nodes identified in the left axillary region.
(1) 3.7 cm irregular mass in the right lower inner breast, corresponding in distribution and location to the mammographically detected calcifications, which span approximately 4.8 cm. Of note, the calcifications in the right breast do extend into the nipple.(2) Prominent right axillary lymph node with eccentric cortical thickening. An MR-directed ultrasound with possible biopsy is recommended for further evaluation.(3) No MRI evidence for malignancy in the left breast.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.