Patient is a 14-year-old female who comes with her grandmother for imaging evaluation of multiple palpable lumps in her right breast. She reports a prior ultrasound revealing presumed fibroadenomata. She feels that some of her lumps have increased in size and some of them are new from the prior examination. A targeted right ultrasound was performed for the palpable areas of concern. Five hypo to isoechoic well-circumscribed masses with internal flow, of similar sonographic morphology are noted in the right breast and are probably fibroadenomata.1. At 9:00 position, 2 cm from the nipple, a palpable mass, increased in size as per patient, is now too big to be measured with ultrasound and is clearly greater than 4 cm.2. At 1:00 position, 2 cm from the nipple, there is a 3.2 x 2.1 x 3.4 cm mass, which is also palpable.3. At 1:00 position, 2 cm from the nipple, adjacent to the second mass, there is a1.1 x 0.7 x 1.2 cm hypoechoic mass, not palpable by patient.4. At 5:00 position, 5 cm from the nipple, there is a 1.3 x 1.2 x 1.4 cm hypoechoic mass, new as per patient.5. At 10:00 position, 5 cm from the nipple, there is a 1.8 x 1.8 cm hypoechoic mass, which is approximately 0.3 cm adjacent to the largest palpable mass (labeled as 1 as above).
Multiple palpable and nonpalpable masses, probably fibroadenomata in the right breast as described above. Surgical consultation is recommended. Results and recommendations were discussed with the patient and her grandmother. BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation.