34 year old female patient with history of right breast mastectomy for invasive ductal carcinoma status post chemoradiation and hormone therapy. She was recently seen in the diagnostic mammography clinic secondary to bloody nipple discharge, at which time a 4 mm hypoechoic lesion was detected posterior to the left nipple on breast ultrasound, for which breast MRI was recommended for further evaluation. There is scattered fibroglandular tissue in the left breast.Moderate parenchymal enhancement is noted in the left breast.There are post surgical changes related to right mastectomy and flap reconstruction, with findings consistent with fat necrosis along the inferior medial aspect of the flap.LEFT BREAST:Fluid is present within dilated subareolar ducts, most prominently at the 12:00 position, which measures approximately 2.8 cm in extent. There is no associated abnormal enhancement or enhancing mass lesion corresponding to the lesion seen on the breast ultrasound examination dated 1/22/2016.Again seen is an approximately 8 mm round septated enhancing mass at the 3:00 position in the left breast, consistent with a fibroadenoma, which is unchanged from the 2014 MRI examination.No abnormal axillary lymph nodes are identified in either axillary region.
Fluid-containing dilated subareolar ducts, most prominently at the 12:00 position, but without associated abnormal enhancement or mass. Ultrasound-guided biopsy of the lesion seen on the prior breast ultrasound is recommended for further evaluation.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.