24 year old with right bloody nipple discharge, with cytology showing atypia. Mild parenchymal enhancement is noted bilaterally. Heterogeneous fibroglandular tissue is present. There are multiple right breast masses. The largest is a branching retroareolar mass near the 10:00-12:00 positions measuring up to 2.6 x 1.9 cm. The next largest mass is located in the 7:00 retroareolar region and measures 1.3 x 0.8 cm. Located 1.6 cm posterior to the main mass is a smaller enhancing mass in the same ductal distribution that measures 0.8 x 0.7 cm. There are multiple bilateral foci and small enhancing masses of benign morphology in each breast which are non-uniquely enhancing and are present outside of the ductal system of the largest mass. No abnormal axillary lymph nodes are identified in either axillary region.
Multiple right breast masses, including a complex branching retroareolar mass near 10:00-12:00, a 7:00 right retroareolar mass and a 12:00 mid to posterior depth mass. These may all represent papillomas. The largest mass was previously seen on ultrasound and is amenable to ultrasound guided biopsy if clinically desired. The smaller masses could be further evaluated with MRI directed ultrasound. Surgical consultation is recommended and the patient has been seen by Dr. Chhablani. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.