EXAM: MRI BREAST BILATERAL W WO CONTRAST
DATE: 12/2/2023 11:58 AM
ACCESSION: 20232514083UN
DICTATED: 12/4/2023 8:53 AM
INTERPRETATION LOCATION: Main Campus

CLINICAL INDICATION: 57 years old Female: New diagnosis of right breast cancer, need to determine extent of disease, rule out contralateral and bilateral axillary nodes ; PERSONAL HX MALIG NEOPLASM BREAST  - C50.911 - Invasive ductal carcinoma of breast, female, right (CMS - HCC)  

TECHNIQUE: Multisequence MR images including precontrast T2 and T1 without fat saturation, and dynamic pre- and post- contrast axial T1- weighted images with fat suppression sequence were performed. Multiplanar reformations, subtracted images, and MIP images were produced. CAD image analysis to include enhancement kinetics were evaluated with DynaCad. 

CONTRAST: The patient received 12.9 mL Multihance intravenously.

COMPARISON: Prior studies

FINDINGS:

FIBROGLANDULAR TISSUE: Scattered fibroglandular tissue.

BACKGROUND PARENCHYMAL ENHANCEMENT:  Asymmetric.

RIGHT BREAST: In the upper outer quadrant of the breast, posterior depth, there is at least a 2.9 cm irregular mass (known biopsy-proven malignancy) containing a signal void artifact corresponding to a marker clip. Along its inferior margin there is a contiguous 0.9 cm oval homogeneous enhancing mass/satellite lesion. The dominant mass abuts the skin and there may be some skin retraction at this site with some enhancement of the overlying skin. Approximately 1.3 cm inferior to the dominant mass, there is is a 2.3 cm irregular enhancing mass (site of second known biopsy-proven malignancy) containing a signal void artifact corresponding to a marker clip (located 9 o'clock position, posterior depth). The second mass abuts the skin with associated skin retraction and there appears to be some enhancement of the overlying skin. There are no other suspicious enhancing masses nor areas of non-mass enhancement. There is no nipple or pectoralis muscle enhancement.

RIGHT AXILLA: A prominent 1 cm level 1 lymph node is present.

LEFT BREAST: There are no suspicious enhancing masses or areas of non-mass enhancement. There is no abnormal skin, nipple, or pectoralis muscle enhancement.

LEFT AXILLA: No axillary lymphadenopathy.

OTHER: No enlarged internal mammary lymph nodes. Visualized portions of the chest and abdomen are unremarkable.

IMPRESSION:
Known biopsy-proven malignancies right breast, as described above, with a prominent 1 cm right level 1 axillary lymph node.

No MRI evidence of malignancy involving the left breast.

ASSESSMENT:
BI-RADS Category: 6-SxExcision : Known biopsy proven Malignancy.  Surgical excision when clinically appropriate.

Recommendation Laterality: Right 
RECOMMENDATION: Clinical follow up for known biopsy-proven malignancy 2 site involving the right breast as described above with a prominent 1 cm level 1 right axillary lymph node.

Note to Provider:  The results and recommendations were not discussed with the patient. Radiology does not contact the patient with breast MRI results. Please order the recommended tests and/or follow-up appointments by calling Breast Imaging 984-974-8762.