0:01

Our next case is a 54-year-old

0:03

woman for high-risk screening.

0:05

She has a history of left breast

0:07

biopsy with a result of atypical lobular hyperplasia,

0:11

and she also has a strong

0:13

family history of breast cancer.

0:16

So we'll take a look at her T1-weighted

0:20

non-fat-saturated study on the left side

0:24

of the screen and her first subtraction

0:26

series on the right side of the screen.

0:29

And on the T1-weighted non-fat-saturated

0:34

sequence, you can see that she has heterogeneous

0:36

fibroglandular tissue and relatively little

0:39

background parenchymal enhancement, so

0:41

mild background parenchymal enhancement.

0:45

In spite of having a lot of tissue.

0:50

We can also see on this T1-weighted image

0:52

that she has a surgical scar here in the left

0:58

lateral anterior breast, and that's from her

1:03

excision of her atypical lobular hyperplasia.

1:06

And there's no abnormal enhancement

1:09

at that excisional biopsy site.

1:14

Look at her MIP study, which shows

1:17

some blood vessels and really not a

1:18

whole lot of enhancement in her breast.

1:22

And then just going back to get her source

1:25

images for T1-weighted fat-saturated pre- and

1:30

post-contrast images, we scroll through those

1:33

together, we can look for areas of enhancement,

1:37

a couple of normal lymph nodes, really nothing

1:42

suspicious here, and of course we look at

1:46

our color map, and T1. Nothing there either.

1:50

So this is BI-RADS 2, basically very close

1:54

to BI-RADS 1, but I would give it a BI-RADS 2

1:56

for the excisional biopsy scar.

2:00

And otherwise, she is looking normal

2:03

and will recommend a follow-up high

2:05

risk screening breast MRI in one year.