MRI
Axial T1
Axial T2
Axial DWI
Axial T1 C+ fat sat
Breast density pattern: type C (heterogenous dense breast fibroglandular pattern).
Background enhancement: mild to moderate.
Right breast:
There is a spiculated lesion of the lower inner quadrant which shows low to intermediate signal intensity on T1WI, T2WI, heterogenously enhanced post contrast and restricted diffusion on DWI. It measures 1.4 x 1.5 cm.
Presence of abnormal dilated vessels adjacent to the lesion suggestive of neovascularity.
Multiple enhancing smaller satellite lesions seen adjacent to the above describe lesion and extending along the duct distribution to the nipple.
Multifocal enhancing right axillary lymphadenopathy. Overlying skin and nipple-areolar complex are also enhanced.
Impression:
Features are in keeping with multicentric multifocal malignant right breast lesions with metastatic axillary lymphadenopathy. BIRADS 6 (HPE proven).