My MRI Report

Since I had it, I wanted to share my MRI report with all of you and see if I can decipher as much as I could. My comments with be in the brackets in light pink.

01/07/2009: BREAST MRI WOW BILATERAL (I don’t know what the WOW means; I am hoping that they were that my breasts were that amazing)

Clinical History: New diagnosis of moderately differentiated invasive ductal carcinoma (Please see previous blog with Dr. W, where he tells me that “moderate” differential is better than “poorly differential).

Comparison is made with the prior studies, most recently dated December 2008.

Technique: Bilateral breast MRI was performed in a dedicated breast coil (this is where I laid face down on a board and put my breast through two holes in the board, I don’t remember any coils), with images acquired in the axial plane. Both short and long TR puls sequences were acquired. Dynamic imaging was performed following gadolinium administration (this was the contrast through the IV). Sagital reconstructed images were reviewed. All images were obtained on a high field, 1.5 Tesla imaging system.

MRI of the breasts demonstrates a moderate volume of fibroglandular tissue bilaterally. There is a 2 cm speculated mass the 8:00 position of the left breast (this is the Alien), corresponding to the newly diagnosed invasive ductal carcinoma. Anterior and lateral to this lesion, there is a second 8-9 mm lesion, consistent with the satellite lesion also recently biopsied (this is Bob). These lesions are approximately 7mm apart. No additional areas of suspicious enhancement are seen within the left breast (Yeah!!). No definite areas of lymph node enlargement are noted (this is good; it means that it hopefully hasn’t spread beyond my breast). There is no abnormal enhancement of the chest wall (also good news).

Within the right breast at 10:00, a linear strand of enhancing avidly enhancing masses is seen (this will now be referred to as the Phantom), extending over a length of approximately 7 cm. The largest lesion is within the posterior third of the right breast, 10cm deep the right nipple, and measures up to 1cm in size. The most anterior lesion measures 7mm, and is approximately 2.5 cm deep to the right nipple. There is no corresponding abnormality of ht mammogram. The enhancement characteristics and distribution are worrisome for additional sites of neoplasm (cancer). I would recommend MRI guided biopsy of the most anterior and posterior (the tails) of these lesions. No enlarged right axillary lymph nodes are noted (yeah!).

Impression:
1) There is a 2 cm speculated mass the 8:00 position of the left breast (once again, this is the Alien), corresponding to the newly diagnosed invasive ductal carcinoma. No additional sites suspicious for malignancy are seen within the left breast.
2) A linear strand of enhancing masses is seen within the 10:00 position (the Phantom) of the right breast, worrisome for contralateral neoplasm. As per the above, I would recommend MRI guided biopsy of the most anterior and posterior of these lesions.