On neoadjuvant chemotherapy, ISPY MRI #2. There is heterogeneous amount of fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.Interval decrease in enhancement within the right breast. The index mass currently measures 1.5 x 1.6 x 1.4 cm, previously up to 2.0 cm, and is somewhat less enhancing. Satellite mass immediately anterolateral to the index mass is not distinctly visualized. Additional small enhancing masses medial to the index mass are also decreased in enhancement--there is now only residual focal and non-mass enhancement along the pectoralis muscle at the site of those masses. Areas of chest wall enhancement are similar to the previous research protocol study. The nonmass enhancement felt to be related to biopsy that became apparent only on the research MRI (after research biopsy), is significantly decreased as well, compatible with resolving post biopsy change.No abnormal enhancement is seen in the left breast. No abnormal axillary lymph nodes are identified in either axillary region.Scattered high T2 liver lesions are not significantly changed, likely representing cysts or hemangiomas.
Some interval decrease in degree of enhancement and size of the right breast index lesion. Additional masses in the right breast are also decreased in size.  BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.