can anyone tell me what all this means please? And yes I had the stereotactic biopsy yesterday
CLINICAL HISTORY: 51-year-old female. Recently performed routine screening mammogram from June 2022 showed increase calcifications in the left breast as well as biopsy-proven invasive mammary carcinoma at 10 o'clock, 7 cm from the nipple. Evaluation with MRI was recommended given the extensive suspicious microcalcifications.
TECHNIQUE: Bilateral breast MRI was performed using a 1.5 Tesla magnet and a dedicated breast coil. 3D volume acquisitions were obtained pre- and post-contrast, using dynamic contrast enhancement with intravenous gadolinium by weight. Correlation with recent mammography and ultrasound was performed.
COMPARISON: No previous MRI for comparison. ADDITIONAL INFORMATION:
1. Left breast ultrasound guided biopsy with clip placement at 10 o'clock, 7 cm from the nipple with pathology showing invasive mammary carcinoma, Nottingham grade 2 out of 3. ER low positive, PR negative, HER - 2 equivocal, FISH performed. Ki 67 = 5%.
2. Ultrasound-guided biopsy at 3 o'clock, 10 cm from the nipple, containing no biopsy clip and showing a benign intramammary lymph node on pathology.
3. Family history of breast cancer in mother at age 50s.
Amount of fibroglandular tissue: There is heterogeneous fibroglandular tissue (ACR type C). Background parenchymal enhancement: Mild symmetric.
There are few small cysts in both breasts.
There is no suspicious mass or non-mass enhancement.
There is a small 2 x 3 mm enhancing focus at 11 o'clock - 12 o'clock in anterior third of the breast (image 95 of subtracted series). It shows a tiny central washout punctate. It is bright on T2 and is not well seen on T1-weighted images.
There are no suspicious axillary or internal mammary lymph nodes. Left breast:
The biopsy-proven cancer is present in the upper inner breast around 10 o'clock radius in mid third containing a biopsy clip (image 117 of series 2) with a spiculated mass, corresponding to the biopsy-proven cancer. It measures 1.1 x 0.9 cm. It shows kinematics mixed kinematics (image 54 of series 40000). 2 small 4 mm enhancing foci are present anterior to the biopsied cancer, better seen on the sagittal images (image 60 and 64 of series 505), likely in keeping with satellite nodules.
There is non-mass enhancement with small enhancing foci in the lateral breast, most significant in the upper outer quadrant of the breast in posterior third (image 135 of subtracted series) .
Similar linear area in central and lower outer breast (image 97 of subtracted series, likely corresponding to the calcification seen on the prior mammogram (image 131 of subtracted series). It shows no kinematics. This area of non-mass enhancement in the lateral breast measures approximately 3.7 x 1.8 cm. It has a segmental extension towards the nipple, however no involvement of the nipple periareolar complex is present.
Postbiopsy changes relating to prior benign biopsy at 3 o'clock radius in posterior third of the breast show mild non-mass enhancement (image 131 of subtracted series).
There are no suspicious axillary or internal mammary lymph nodes. Others:
No abnormality on the limited images of the extramammary structures. IMPRESSION:
No suspicious mass.
Tiny focus of enhancement at 11 o'clock - 12 o'clock in anterior third of the breast is probably benign, can be evaluated with a follow-up MRI breast examination at 6 months.
Biopsy-proven cancer at 10 o'clock radius in mid third of the breast containing a biopsy clip showing a small spiculated mass.
Extensive non-mass enhancement in the lateral breast with a linear configuration at 3 o'clock - 4 o'clock radius. Given that suspicious calcifications are present on the prior mammogram, left breast stereotactic biopsy will be performed
Right breast: BI-RADS: 3- Probably benign findings.
Left breast: BI-RADS: 4B- Suspicious, pending stereotactic biopsy. Recommendations:
1. Left breast stereotactic biopsy.
2. Follow-up MRI breast examination at 6 months.
We leave this for your office to coordinate and send in the request thank you.