HISTORY: 44 year old woman with history of treated T2N1 right breast cancer status post lumpectomy, known ataxia telangiectasia-mutated (ATM) gene, and heterogeneously dense breasts presented for high risk screening.
Summary of prior imaging:
Mammography: Breast conserving therapy (BCT) changes right breast, postoperative changes in the right axilla and stable benign appearing 0.9 mass left breast 3:00 middle depth.
Ultrasound: None applicable
Breast MRI: No evidence of malignancy, BCT changes right breast and benign cysts with rim enhancement left breast
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 are two inflammatory cysts in the left breast laterally. There are no suspicious enhancing masses. No axillary or internal mammary lymphadenopathy is seen. There is no abnormal skin or pectoralis muscle enhancement.
Left breast lesion 1
Lesion type: Mass
1.4 cm. Lower outer Quadrant. 3:30 Radian. 4.5 cm from the nipple.
Mass/post-surgical change: Shape:Round. Margins:Circumscribed. Enhancement: Rim.
BI-RADS:2: Benign
Left breast lesion 2
Lesion type: Mass
1.2 cm. Lower outer Quadrant. 4:00 Radian. 4.5 cm from the nipple.
Mass/post-surgical change: Shape:Round. Margins:Circumscribed. Enhancement: Rim.
BI-RADS:2: Benign
Lymph nodes LEFT: ☒Normal axilla
RIGHT BREAST
Narrative
The right breast is smaller is size, with architectural distortion in the central breast. Postoperative changes are present in the breast and axilla and the nipple is absent. There are no suspicious enhancing masses. No axillary or internal mammary lymphadenopathy is seen. There is no abnormal skin 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: 2: Benign: Routine breast MRI screening if cumulative lifetime risk =>20%
Non-enhancing findings RIGHT breast: ☒Post therapy architectural distortion ☒Signal voids in skin and subdermal fat
Lymph nodes RIGHT: ☒Normal axilla status post node removal
Extramammary findings: None
SUMMARY: Benign left breast enhancing cysts, right BCT
LEFT BI-RADS:2: Benign
RIGHT BI-RADS:2: Benign
