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BI-RADS 4 – New Diagnosis Left Cancer, Focal NME left

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And our next case is a 48-year-old woman with a

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recent diagnosis of left breast cancer, and MRI

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was performed to evaluate extent of disease.

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We'll go to her MIP and just show you this.

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So the patient has a large enhancing mass in the

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left breast, and this was a known breast cancer.

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And she also has some moderate

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background parenchymal enhancement.

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So we're going to take a look at some other

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series and investigate this a little bit more.

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So again, I'm pulling her

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T1-weighted and first subtracted

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series.

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You can see that she has heterogeneous

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fibroglandular tissue and

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moderate background enhancement.

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There's a lot of little,

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little foci, little spots that enhance

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and background enhancement.

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As we go through the left breast,

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you can see this irregular mass.

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There is a susceptibility artifact from

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a biopsy clip centrally, and that's the

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area where her biopsy clip is located,

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and that was her known breast cancer.

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And as we scroll through, there's a lot of

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background enhancement, but there's one area

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that stood out as being a little bit different

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to us, and it was right here, kind of in the

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same plane or at the same level as her mass.

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She had a little area of non-mass

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enhancement, focal non-mass enhancement,

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and we elected to biopsy this

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after, you know, further evaluation.

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But basically we looked at,

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you know, all of her exam and

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nothing else really stood out like this did.

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So the biopsy was performed and that was

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benign, benign breast tissue and something

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called pseudoangiomatous stromal hyperplasia,

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which is abbreviated as PASH, P A S H.

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And that's actually a fairly common

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result when we do MRI-guided biopsies

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of areas of non-mass enhancement.

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So that was our finding here.

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So because this was benign, the patient

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was able to go on to a lumpectomy,

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just involving the known breast cancer.

Report

Description

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Women's Health

Neoplastic

MRI

Breast

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