Ms. Williams is a 34-year-old female with a personal history of left breast lumpectomy in February 2013 for triple negative IDC. Patient did not receive any chemotherapy or radiation therapy. She has no current breast related complaints. There are innumerable scattered foci of enhancement seen in both breasts, compatible with marked background parenchymal enhancement. Left breast: Postsurgical changes are identified in the upper outer left breast, at site of prior lumpectomy. In the left lateral breast, anterior to the lumpectomy site, there is a 3.5 cm span of linear non-mass-enhancement identified with persistent type kinetics. This was not definitively seen on prior MRI. Right breast: Few scattered cysts are seen in the right breast. No abnormal enhancement is identified in the right breast. No abnormal axillary lymph nodes are identified in either axillary region.
(1) 3.5 cm span of linear non-mass-enhancement in the lateral left breast located anterior to the lumpectomy changes. MR-guided biopsy is recommended for further evaluation. (2) Bilateral marked background parenchymal enhancement, which lowers the sensitivity and specificity of MRI. Of note, MRI is optimally performed during the second week of the patient's menstrual cycle.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.All results and recommendations were relayed to Nanna Sulai on 2/18/2015. 