HISTORY: 79 year old lady, history withheld.
Summary of prior imaging
Mammography: Normal
Ultrasound: Normal
Breast MRI: NA
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:
Associated findings LEFT breast: X 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 breast: ☐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: ☐Fat necrosis, ☐Hamartoma, ☐Post-operative seroma/hematoma with fat
Lymph nodes LEFT: ☒Normal axillary, ☐Abnormal axillary, ☐ Abnormal internal mammary
RIGHT BREAST
Narrative: 6cm segmental sub threshold non-mass enhancement in the lateral right breast extending to the nipple with right nipple enhancement and thickening. 1.5 cm cyst RUIQ.
Right breast lesion 1
Lesion type: Non-mass enhancement
6 cm. Upper outer Quadrant. 9:00 Radian. 0-6 cm from the nipple
Non mass enhancement: Distribution: Segmental, Internal enhancement: Clumped, Kinetics: -subthreshold
BI-RADS:4: Suspicious abnormality – Biopsy should be considered
Associated findings RIGHT breast: ☐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: ☐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: ☐Fat necrosis, ☐Hamartoma, ☐Post-operative seroma/hematoma with fat
Lymph nodes RIGHT: ☒Normal axillary, ☐Abnormal axillary, ☐ Abnormal internal mammary
Extramammary findings: None
SUMMARY: Segmental clumped enhancement in the right breast highly suspicious for DCIS. Asymmetric right nipple enhancement suspicious for nipple involvement.
LEFT breast BI-RADS:1: Negative
RIGHT BI-RADS:4: Suspicious abnormality – Biopsy should be considered
RECOMMENDATIONS: MRI guided biopsy of right breast lesion 1
