43 year old female with BRCA 1 mutation. Personal history of benign right breast biopsy in 2003 as well as an FNA aspiration of a right breast nodule at 7 o'clock in 2009 compatible with a fibroadenoma. Family history of breast carcinoma in her sister at age 36, in two paternal aunts in their 40s, and a grandmother. Extremely dense breast tissue is present. On postcontrast images, moderate parenchymal enhancement is seen bilaterally.RIGHT BREAST: There is an ovoid homogeneously enhancing mass in the posterior right breast, approximately 7:00 position. This mass measures 2.0 x 1.3 x 1.5 cm and is not associated with a biopsy clip. However, it corresponds to ultrasound findings from 2014 and the reported site of FNA aspiration biopsy in 2009 confirming a fibroadenoma. Located just anterior to this mass, there is another smaller lesion compatible with fibroadenoma, also seen on prior ultrasound from 2014.At approximately the 10 to 11:00 position, posterior depth there is a 1.6 x 0.9 x 1.8 cm circumscribed mass that demonstrates slow but homogeneous enhancement. This mass is also most likely a fibroadenoma and was seen on prior ultrasound exam, mostly unchanged.LEFT BREAST:No abnormal enhancement is identified. No abnormal axillary lymph nodes are identified in either axillary region. Multiple T2-hyperintense lesions in the liver may represent cysts or hemangiomas but are incompletely characterized.
Multiple benign morphology masses in the right breast with sonographic correlates as described above. These most likely represent fibroadenomas, and the largest of these at the 7:00 position is an FNA biopsy-proven fibroadenoma. No MRI evidence for malignancy. Annual surveillance with diagnostic mammogram and ultrasound is recommended.Annual surveillance MRI is also recommended given the patient's genetic susceptibility. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. 