What was the BiRADS on your initial MRI? That would help guide a decision on biopsy or not. It is well known in breast radiology research that malignancy and fat necrosis can mimic each other on MRI. I had washout and clustered-ring enhancement, both of which characterize malignancy AND fat necrosis. So, enhancement rate, distribution pattern and morphology can be similar in both, such as your hypoechoic, washout and rapid enhancement. My Nov '23 MRI was BiRads-4 and my report did say suspicious of malignancy but could consider other etiologies such as fat necrosis. Biopsy was recommended and the biopsy last week did in fact turn out to be fat necrosis, but could have gone the other way, too. There are specific criteria for evaluation of lymph nodes on MRI such as 3-D measurement, border characteristics etc. I guess I would wonder what "fluffy" means. I had some concerning lymph characteristics on MRI last December, this year normal. There are a lot of physical and environmental variables that effect lymph nodes at any given time, such as immune responses, timing of COVID vax to MRI, and myriad of others. My own experience with the lymph nodes is that they wouldn't biopsy nodes unless high correlation with breast lesion, and more generally done during a lumpectomy. Sometimes these varying medical opinions have necessitated my getting into the weeds, educating myself on the research, and asking specific questions of the medical team so I'm more comfortable with their evaluations. In the lead-up to my biopsy, I did a ton of reading and this website was particularly helpful for the plain language they use. Disclaimer: I'm an ex-RN. This article is about fat necrosis and I hope it's helpful to you. In addition to Advocate, Advocate, Advocate...I would also add Question, Question, Question (who, what, where, when and WHY... on everything!) https://ajronline.org/doi/10.2214/AJR.07.4051