Ms. Toy is a 46-year-old female who presents for short-term follow-up of mass in upper outer quadrant of left breast. A targeted left ultrasound was performed at the site of the previously described mass.In the left breast 1:00 location, approximately 4 cm the nipple, there is a circumscribed, lobulated hypoechoic mass most likely representing a benign fibroadenoma measuring 1.2 x 0.7 x 1.0 cm, previously 1.2 x 0.6 x 1.0 cm.
High probability benign mass of the left breast, likely representing a fibroadenoma. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram and possible left breast ultrasound is recommended in 6 months in order to ensure stability of these findings. All results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months).