Ms. LINDA COLLINS is a 46 years old female with a personal history of lumps in both her breasts since she was 20 years old. Prior exam demonstrated bilateral benign-appearing masses, with six-month follow-up recommended. The patient is currently menstruating. ULTRASOUND:On physical examination, palpable masses were noted at the 12:00 position approximately 1 cm from the nipple, in both breasts.A targeted bilateral ultrasound was performed for both breasts.Right breast: Again seen is a well-circumscribed hypoechoic mass at the 12:00 position, approximately 1 cm from the nipple, which now measures 14 x 25 mm, previously 14 x 28 mm. A clustered cyst is again noted 3 cm from the nipple at the 12:00 position, now measuring 12 x 6 mm, previous 5 x 9 mm.Left breast: A well-circumscribed hypoechoic lesion is again seen at the 12:00 position, 1 cm from the nipple, now measuring 32 x 22 mm, previously 23 x 15 mm. An additional well-circumscribed hypoechoic lesion is again seen at the 1:00 position, 10 cm from the nipple, which now measures 12 x 16 mm, previously 10 x 17 mm.
1.Interval increase in size of the dominant left breast mass, with characteristics most suggestive of a fibroadenoma, with interval increase in size felt likely related to menstrual cycle timing. However, six-month follow-up is recommended. Stable other benign fibroadenoma in the left breast 1:00 position and right breast 12:00 position. Surgical consultation is also recommended given interval increase in size.2.Slight interval increase in size of the clustered cyst in the right breast. Six month follow-up is recommended.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (6 Months).