Ms. Zhang is a 22-year-old female presenting with a left breast mass and pain for three days. On physical examination, no palpable abnormality was identified in the left breast. Targeted ultrasound of the left lateral breast demonstrates a circumscribed hypoechoic mass in the 3:00 position 1 cm from the nipple measuring 4 x 4 x 6 mm with peripheral vascularity.
High probability benign morphology mass in the left breast, likely representing a fibroadenoma. A short-term 6 month ultrasound is recommended in 6 months in order to confirm stability of these findings. These findings were discussed with the patient at the time of examination.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months).