42-year-old male with new palpable right breast mass. Family history is positive for breast cancer in mother diagnosed at 60 years of age, as well as in 2 paternal aunts and a great niece. Patient has heterogeneously dense breast parenchyma, and the study is performed under Allenton protocol. Mild background parenchymal enhancement is noted bilaterally.Within the right breast, at the 6:00 position, there is an irregular heterogeneously enhancing mass measuring 3.3 x 2.1 x 1.8 cm. A 5 mm enhancing focus is also present in the medial right breast at the 4:00 position. This latter focus presents the heart internal septations on the T2 image, findings suggestive of a fibroadenoma.No abnormal enhancement is seen in the left breast. No abnormal lymph nodes are identified in either axillary or internal mammary region.
1. Highly suspicious 6:00 right breast mass, should undergo ultrasound-guided biopsy.2. Nonspecific benign-appearing enhancing focus in the right medial breast, with imaging characteristics suggestive of fibroadenoma. MRI guided ultrasound of the right medial breast recommended, preferably at the time of other 6:00 right breast mass biopsy, for further evaluation.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.