27-year-old with history of fibrocystic disease and left bloody nipple discharge from a single duct. Mother with history of breast cancer. There is heterogeneous amount of fibroglandular tissue in both breasts. Numerous high T2 cysts are present bilaterally. Marked parenchymal enhancement is noted bilaterally. This is a limitation to this exam. There is also motion artifact which limits the subtraction images. There is high T1 signal fluid in bilateral retroareolar ducts, most notable in multiple ducts near the left 12:00 position. Subtraction images are limited for evaluating ductal enhancement, but when comparing pre and post T1 images at the level of the duct fluid, the degree of high T1 signal appears largely stable. Numerous benign morphology masses are present bilaterally. The largest is the biopsy proven benign mass in the right upper outer breast which measures 1.2 x 0.9 x 1.4 cm. This mass has internal artifact from a biopsy clip. No morphologically suspicious mass is seen in either breast. This imaging and follow up were discussed for consensus opinion among three breast radiologists. No abnormal lymph nodes are identified in either axillary region.
Limited MRI showing multiple bilateral benign morphology masses and extensive background enhancement. High signal fluid is seen within ducts bilaterally, left greater than right. Motion artifact limits the exam, but there is no definite suspicious ductal enhancement seen. A 6 month MRI follow up is recommended to evaluate the stability of the masses, and should be performed during the second week of her menstrual cycle to maximize the utility of the follow up study. Clinical correlation for her nipple discharge is also recommended.These results and recommendations were discussed with Dr. Jaskowiak. BIRADS: 3 - Probably benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter.