guide me

dear sir 

my name is beena doshi i am 34 year old , i am unmarried , i am from india 

Multiplanar multi echo contrast enhanced MRI of both the breast been performed using a dedicated breast coil before  and after intravenous administration of gadolinium DTPA.

Images have been further processed to assess the kinetics if any.

Patient is status post excision of a right outer quadrant mass which was diagnosed to be an invasive ductal carcinoma

Significant amount of glandular tissue is noted in both the breasts which demonstrates moderate Background enhancement.

A focal irregular T2 bright area is visualized in the lower outer quadrant of the right breast measuring six x 4.6 x 4.3cm in size . it extends up to the chest wall with irregularity of the right pectoralis muscle noted. It appears hyperintense on the  T1-weighted images as well with focal T2 isointense areas within suggestive of presence of proteinaceous or haemorrhagic material within. The area displays a thin enhanching rim

Which is best appreciated in the delayed phase. It measures up to 6 mm in maximal width at the site of the Surgical scar. There is no evidence of a focal mass in relation to it

Exaggerated ill-defined parenchymal enhancement is visualized in the superolateral quadrants bilaterally.

There is no evidence of a focal lesion within the right breast tissue.

A focal micro-lobulated mass is visualized at the 12 o’clock position within the left breast measuring 19 x 14 x 14 mm in size . this lesion appears bright on the T2-weighted images . it displays a rapid wash in with sustained type of enhancement (type 2 curve). Multiple nonenhancing hypointence septi are visualized

Within it best appreciated in the second phase of contrast administration

Exaggerated parenchymal enhancement is visualized in the lateral quadrants of the left breast with few tiny foci seen it the inferolateral quadrant measuring up to 3 mm in maximal diameter.

No other area of abnormal enhancement is detected.

The nipple and retro areolar regions are unremarkable. Enlarged right axillary lymph node measuring up to 1.3 cm in short axis are  seen. Subcentimetre sized left axillary nodes are detected.

Impression : in a recently diagnosed case of intraductal carcinoma of the right breast, a postoperative cavity is visualized in the lower outer quadrant of the right breast containing heamorrhagic / proteinaceous material. There is no evidence of a residual lesion surroundind the surgical cavity or elsewhere within the right breast .

A micro lobulated enhancing mass is visualized at the 12 o’clock position within the right the breast with morphological features suggestive of a benign aetiology ? Fibroadenoma. however in view of the clinical setting biopsy correlation is recommended.

thanking you