 So our next case is a 42-year-old woman with a recent diagnosis of right breast cancer, which was initially discovered on a baseline screening mammogram as a right retrorheal or mass. And that mass was biopsied and found to be an invasive ductal carcinoma, which was kind of a surprise. And she had fairly dense breasts on mammography, the size of the tumor was a little bit unclear based on the mammogram and ultrasound. So MRI was requested for evaluation of extent of disease. So here's the patient's mip, which really shows a lot going on here in the right breast. So the area behind the nipple that had been biopsied was just this mass. But you can see that there's a lot more going on in the right breast. There's some non-mass enhancement. There may be other masses. There's a suggestion of a lymph node here in the axilla. And she has a fair amount of background prankimal enhancement as well. So we'll go ahead and look at this a little bit more closely. We'll pull in our T1 and our post-contrast sub. And you can see that this patient has a lot of fibroglangular tissue. And on a mammogram, that would manifest as breast tissue density. So she does have heterogeneously dense to dense breasts on mammography. And that was making it difficult to interpret her mammogram. But on her MRI, you can see that even in places with denser tissue or more fibroglangular tissue, she doesn't really enhance very much. But then on the right breast, she has a lot of enhancement. So the area that was biopsied was this mass. So that's an invasive ductal carcinoma. But then she had this surprising amount of non-mass enhancement in the lateral right breast extending from front to back. And then another mass or masses posteriorly, most of her issue is here in the central breast to upper breast, but it does extend lower as well. And there are a few other masses in the medial breast as well here anteriorly and posteriorly. And she also has multiple large lymph nodes in the right axilla that are enhancing several large lymph nodes. So we looked at this with our source images as well, T1, pre and post contrast. And you can see the same findings, particularly these large axillary lymph nodes. So we read this as a biorets for, because what we wanted to do was biopsy or do a second loc ultrasound and biopsy of one of those right axillary lymph nodes. And there was some discussion before reading this as to whether she would need anything else done in the breast on the right. All of this enhancement was suspicious on the right kind of biorets 4 slash 5, almost certainly cancer. We elected not to do additional biopsies in the right breast because it was felt that this would probably be needing to be a mastectomy. And we went ahead and did a biopsy, ultrasound guided biopsy of a lymph node in the right axilla and that showed metastatic disease. So this was biorets 4. And I think in some of these cases there's a fine line between biorets 4 and 5. This is almost certainly going to be a cancer. So biorets 4 or 5 would be appropriate here.