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Our next set of cases

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was coded as BI-RADS category 2.

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So, our first case is a 47 year old woman for high risk screening.

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She has a history of left breast cancer diagnosed in 2015,

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treated with lumpectomy and radiation therapy.

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She also has a history of benign,

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right breast biopsy and a strong family history of breast cancer.

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So here's our MIP on the left side of the screen,

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you can see blood vessels kind of mild enhancement,

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a few scattered foci of enhancement. We'll take a look at our

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first subtraction image, as well as our T1

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non-fat saturated image,

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and just scroll through those.

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And we can see a few things.

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So on the T1-weighted series,

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This is susceptibility artifact

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here in the right posterior lateral breast from a biopsy clip.

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And then, we can see the patient's lumpectomy site

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here in the left posterior lateral breast,

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and their susceptibility artifact from surgical clips,

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as well as scarring at the lumpectomy site

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that extends out to the patient's skin.

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So, that's her lumpectomy site.

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Again, more clip artifact.

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And these are typical findings at a lumpectomy

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site and a little bit of distortion there.

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And again, as we're scrolling through,

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we're noticing that there's not really any significant

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enhancement here at the lumpectomy site,

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in that same area.

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And as far as our background parenchymal,

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this is probably a scattered fibroglandular tissue.

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And then our background parenchymal enhancement is

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pretty mild, and a few enhancing foci.

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In this patient, we did have prior exams for comparison.

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So we knew that all of the foci were similar to previous exams.

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We have our STIR images

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which shows some edema at the lumpectomy site.

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Sometimes there's a seroma, little fluid collection

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that you can see at the lumpectomy site as well.

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And also a few T2 bright masses which don't enhance,

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so they're probably cysts.

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So we have pre contrast on the left and post contrast

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on the right and we can scroll through those also.

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This is why the subtracted images are so useful because I think

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it would be difficult. Her tissues relatively bright on T1,

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so it's little harder to see the enhancing areas.

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But basically,

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this patient has a biopsy clip on the right, lumpectomy site on the

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left a few scattered foci of enhancement that were stable and

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nothing new. So this is considered a BI-RADS 2 exam.