Fig 7.

A 42-year-old woman, with a family history of breast malignancy, presented with (A) left breast upper inner quadrant fine-linear calcifications (arrow) on screening mammography. The patient underwent stereotactic core-needle biopsy yielding invasive ductal carcinoma, grade 2, estrogen receptor/progesterone receptor/human epidermal growth factor receptor 2 positive. The patient had received the first dose of the Moderna coronavirus disease 2019 vaccine in the left deltoid muscle 12 days before preoperative MRI. (B) Axial T1-weighted fat-saturated postcontrast subtracted MR image demonstrated 9 mm of nonmass enhancement corresponding to the biopsy-proven malignancy and a small hematoma (arrow). (C) Axial T1-weighted fat-saturated postcontrast MR image demonstrated level 1 and level 2 axillary lymphadenopathy (arrows). No additional findings were detected in the left or right breast, in keeping with unifocal malignancy. (D) Targeted left axillary ultrasound demonstrated corresponding lymphadenopathy with cortical thickening up to 6 mm (arrow). In consultation with the patient’s breast surgeon, the decision was made to pursue axillary lymph node biopsy. (E) Subsequent ultrasound-guided biopsy of lymph node (arrow) demonstrated (F) fragments of reactive lymph node negative for carcinoma. Image courtesy of Drs Veerle Bossuyt and Melanie Kwan, Anatomic Pathology.