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Click 60 year old female status post left breast modified radical mastectomy and left axillary lymph node dissection followed by left breast reconstruction with a standard dual-lumen breast implant, with biopsy-proven silicone lymphadenitis of contralateral (right) axillary and intramammary lymph nodes. Pre biopsy axial T1 weighted MR 1 minute post contrast subtracted image (TR 3.69 TE 1.35; 1.5T Siemens MAGNETOM Sonata MRI scanner using breast phased array coil; matrix 320x320; 18 cc of Prohance) demonstrates enlarged lymph node with cortical thickening in the left internal mammary chain measuring 1.6 x 0.9 x 1.4cm; enlarged lymph node with cortical thickening in the right axilla measuring 1.5 x 0.9 x 1.3cm; and enlarged lymph node with cortical thickening in the right breast upper outer quadrant measuring 1.0 x 0.8 x 1.4cm.

Click 60 year old female status post left breast modified radical mastectomy and left axillary lymph node dissection followed by left breast reconstruction with a standard dual-lumen breast implant, with biopsy-proven silicone lymphadenitis of contralateral (right) axillary and intramammary lymph nodes. Pre biopsy sagittal T1 weighted MR 6 minute post contrast subtracted image (TR 3.69 TE 1.35; 1.5T Siemens MAGNETOM Sonata MRI scanner using breast phased array coil; matrix 320x320; 18 cc of Prohance) demonstrates enlarged lymph node with cortical thickening in the left internal mammary chain measuring 1.6 x 0.9 x 1.4cm; enlarged lymph node with cortical thickening in the right axilla measuring 1.5 x 0.9 x 1.3cm; and enlarged lymph node with cortical thickening in the right breast upper outer quadrant measuring 1.0 x 0.8 x 1.4cm.

Click 60 year old female status post left breast modified radical mastectomy and left axillary lymph node dissection followed by left breast reconstruction with a standard dual-lumen breast implant, with biopsy-proven silicone lymphadenitis of contralateral (right) axillary and intramammary lymph nodes. Pre biopsy axial STIR MR image (TR 4000 TE 72; 1.5T Siemens MAGNETOM Sonata MRI scanner using breast phased array coil; matrix 384x384) demonstrates an intact standard dual lumen (inner silicone, outer saline) breast implant in a reconstructed left breast.

Click 60 year old female status post left breast modified radical mastectomy and left axillary lymph node dissection followed by left breast reconstruction with a standard dual-lumen breast implant, with biopsy-proven silicone lymphadenitis of contralateral (right) axillary and intramammary lymph nodes. Pre biopsy axial fusion image from an FDG PET/CT exam performed 90 minutes after the injection of 13.8 mCi of FDG demonstrates a morphologically abnormal right axillary lymph node measuring 1.4 x 0.9cm, without a central fatty hilum with increased metabolic activity with SUVmax of 1.95; and a morphologically abnormal left internal mammary lymph node measuring 1.6x1.0cm with increased metabolic activity with SUVmax of 1.67.

Click 60 year old female status post left breast modified radical mastectomy and left axillary lymph node dissection followed by left breast reconstruction with a standard dual-lumen breast implant, with biopsy-proven silicone lymphadenitis of contralateral (right) axillary and intramammary lymph nodes. Pre biopsy gray scale ultrasound image of the right breast using a high frequency linear probe demonstrate markedly hyperechoic intramammary lymph node with snow storm artifact measuring 1.3 x 0.9 x 0.8 cm; markedly hyperechoic axillary lymph node with snow storm artifact measuring 1.5 x 1.5x 1.0 cm; and markedly markedly hyperechoic axillary lymph node with snow storm artifact in the left internal mammary chain.