38-year-old female with surgery of bloody left nipple discharge for one month. A solid, hypoechoic lesion in the left breast was noted on previous ultrasound. There is a heterogeneous amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.There is an enhancing lesion in the left posterior breast at the 4:00 position, which measures 10 x 6 x 11 mm (series 500, images 6-9), with morphology is most suggestive of a fibroadenoma. This lesion demonstrates mixed kinetics. Additionally, there is a smaller lesion in the left breast at the 3:00 position, slightly lateral to the aforementioned lesion which measures 8 x 4 x 3 mm (series 500, images 2-4). This lesion also demonstrates mixed kinetics. An enhancing lesion in the left posterior central breast has benign kinetics, measuring approximately 4 mm, the morphology of which may represent a fibroadenoma versus a benign intramammary lymph node. There is an additional small enhancing lesion immediately lateral to the lesion at the 4:00 position, measuring approximately 3 mm, which may also represent a fibroadenoma versus a benign intramammary lymph node.No abnormal axillary lymph nodes are identified in either axillary region.
Enhancing lesions in the left breast, some of which have morphology suggestive of fibroadenomata. Biopsy of the two largest/most suspicious masses is recommended.Please note ultrasound-guided biopsies of the masses at the 3:00 and 4:00 positions were performed on the same date.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.