Wk 1, Case 2 - Review

HISTORY: 29 year old woman with BRCA2 gene mutation presented for high risk screening

Summary of prior imaging:

Mammography: Negative 1 year earlier

Ultrasound: None

Breast MRI: None

FINDINGS

Quality control issues: ☒None ☐Poor/lack contrast bolus ☐Poor fat suppression
☐Susceptibility ☐Movement ☐Other

Background Parenchymal Enhancement: Minimal
Amount of Fibroglandular Tissue: Heterogenous glandular tissue

LEFT BREAST

Narrative
There is 2.6 cm linear non-mass enhancement in the left lower inner quadrant that extends from the nipple areolar complex to the posterior depth. There are no suspicious enhancing masses. No axillary or internal mammary lymphadenopathy is seen. There is no abnormal skin, nipple, or pectoralis muscle enhancement.
Left breast lesion 1
Lesion type: Non-mass enhancement
2.6 cm. Lower inner Quadrant 7:00 Radian 1cm from the nipple

Non-mass enhancement: Distribution: Linear
Kinetics: upslope- Medium, delayed-Plateau
BI-RADS:4: Suspicious: Tissue diagnosis

Associated findings LEFT: ☒NONE, ☐Nipple retraction, ☐Nipple involvement, ☐Skin retraction, ☐Skin thickening, ☐Skin invasion-direct, ☐Skin invasion-inflammatory, ☐Pectoral muscle invasion, ☐Chest wall invasion, ☐ Architectural distortion

Non-enhancing findings LEFT: ☒NONE, ☐High ductal signal pre contrast T1, ☐Cyst(s), ☐Hematoma/seroma, ☐Post therapy skin/trabecular thickening, ☐Non-enhancing mass, ☐Architectural distortion, ☐Signal void from clips

Fat containing lesions LEFT: ☒NONE, ☐Fat necrosis, ☐Hamartoma, ☐Post-operative seroma/hematoma with fat

Lymph nodes LEFT: ☒Normal axillary, ☐Abnormal axillary: description, ☐ Abnormal internal mammary: description

RIGHT BREAST

Narrative
There are no suspicious enhancing masses or areas of non-mass enhancement. No axillary or
internal mammary lymphadenopathy is seen. There is no abnormal skin, nipple, or pectoralis
muscle enhancement.

Right breast lesion 1
Lesion type: Choose an item.
Longest measurement cm. Choose an item Quadrant. Choose an item. Radian. dist from nipple cm
from the nipple

BI-RADS: 1: Negative: Routine breast MRI screening if cumulative lifetime risk =>20%

Associated findings RIGHT: ☒NONE, ☐Nipple retraction, ☐Nipple involvement, ☐Skin retraction, ☐Skin thickening, ☐Skin invasion-direct, ☐Skin invasion-inflammatory,
☐Pectoral muscle invasion, ☐Chest wall invasion, ☐ Architectural distortion

Non-enhancing findings RIGHT: ☒NONE, ☐High ductal signal pre contrast T1, ☐Cyst(s), ☐Hematoma/seroma, ☐Post therapy skin/trabecular thickening, ☐Non-enhancing mass, ☐Architectural distortion, ☐Signal void from clips


Fat containing lesions RIGHT: ☒NONE, ☐Fat necrosis, ☐Hamartoma, ☐Post-operative seroma/hematoma with fat

Lymph nodes RIGHT: ☒Normal axillary, ☐Abnormal axillary: description, ☐ Abnormal internal mammary: description

Extramammary findings: None

SUMMARY: Suspicious NME left breast

LEFT BI-RADS: 4: Suspicious abnormality: Tissue diagnosis
RIGHT BI-RADS: 1: Negative: Routine breast MRI screening if cumulative lifetime risk =>20%