The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
A 37-year-old woman presented to a breast clinic with a 5-year history of multiple lumps in her breasts. She had no comorbidities.
The patient had undergone surgical excision of benign lumps in both breasts on two occasions during the past 5 years. She had no family history of breast cancer or ovarian cancer. She had two full-term pregnancies.
The results of a general physical examination and routine blood tests were unremarkable; however, spotty pigmentation of the skin was noted. A local breast examination revealed very nodular, tender breasts. The largest lumps in both breasts were approximately 40 mm. Scars from previous surgery were visible on the breasts.
An ultrasound examination of both breasts showed numerous well-defined isoechoic nodules studded in the breasts. The larger nodules measured up to 4-4.5 cm (Breast Imaging Reporting and Data System [BI-RADS] 4A).
Because of the extensive nature of the florid benign breast changes, it was challenging to characterize the multiple lumps on ultrasound examination alone. Hence, a breast contrast-enhanced MRI (CEMRI) was ordered; it showed extensive bilateral BI-RADS 3 lumps, which were suggestive of fibroadenomas (Figure 1).
Tru-Cut biopsy of the largest lumps in both breasts was performed, and the diagnosis of fibroadenoma was confirmed. The patient was advised to remain under close follow-up for clinical checkups and serial ultrasounds.
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Cite this: Kanchan Kaur. Oncology Case Challenge: A 37-Year-Old Woman With Multiple Fibroadenomas - Medscape - Mar 01, 2022.