ABSTRACT
A 17-year-old African-American girl is referred by her family doctor for right-sided breast enlargement. The patient had first noted a right-sided breast mass approximately 1 year previously. An ultrasound obtained by her physician at the time showed a benign-appearing mass measuring 4.5 × 2.8 × 3.6 cm. A decision was made to observe the mass without surgical consultation. The patient became more concerned recently after her soccer teammates commented on asymmetry of her breasts during postgame showers. She has no breast pain or nipple discharge. Her mother had a breast biopsy at age 40 for calcifications that were found to be benign. On examination, the right breast appears visibly larger than the left. The skin and nipples of both breasts are normal. A large, firm, mobile, nontender mass, measuring approximately 8 cm in greatest dimension occupies the entire lower outer quadrant of the right breast. There is no cervical or axillary lymphadenopathy. The remainder of the physical exam is normal.
