HISTORY: 32 year old female presents for high risk screening MRI
Summary of prior imaging
Mammography: Scattered fibroglandular densities. Normal mammogram.
Ultrasound: NA
Breast MRI: NA
FINDINGS
Quality control issues: ☐None ☐Poor/lack contrast bolus ☒Poor fat suppression
☐Susceptibility ☐Movement ☒Other: Positioning of the anterior breast is poor
There is indenting and flattening of the anterior most portion of both breasts. There is poor fat suppression in these regions.
Background Parenchymal Enhancement: Minimal
Amount of Fibroglandular Tissue: Scattered fibroglandular tissue
LEFT BREAST
Narrative: No suspicious enhancement or lymphadenopathy.
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, ☐ Abnormal internal mammary
RIGHT BREAST
Narrative: No suspicious enhancement or lymphadenopathy.
Associated findings RIGHT breast: ☒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 breast: ☒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: Suboptimal positioning for MRI, limiting evaluation of the anterior portion of both breasts. No suspicious enhancement or lymphadenopathy.
LEFT BI-RADS: 1: Negative: Routine breast MRI screening if cumulative lifetime risk =>20%
RIGHT BI-RADS: 1: Negative: Routine breast MRI screening if cumulative lifetime risk =>20%
RECOMMENDATIONS: Continue high risk screening MRI and annual screening mammogram.
