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Case number:	174
Age:	43
Clinical presentation:	Premenopausal woman with average risk of developing breast cancer presented with bilateral mastalgia. On examination, no abnormality was detected.

Mammography:

Breast composition:	ACR category b (there are scattered areas of fibroglandular density)
Mammography features:
‣ Location of the lesion:	Right breast, upper outer quadrant at 10 o’clock, anterior third, typically benign coarse calcifications
‣ Mass:
• Number:	1
• Size:	1.4 cm in greatest dimension
• Shape:	Oval
• Margins:	Circumscribed
• Density:	Equal
‣ Calcifications:
• Typically benign:	Coarse (right), popcorn-like (left)
• Suspicious:	None
• Distribution:	In mass
‣ Architectural distortion:	None
‣ Asymmetry:	None
‣ Intramammary node:	None
‣ Skin lesion:	None
‣ Solitary dilated duct:	None
‣ Associated features:	None

Mammography features:
‣ Location of the lesion:	Left breast, lower inner quadrant at 8 o’clock, posterior third, typically benign popcorn-like calcifications
‣ Mass:
• Number:	1
• Size:	2.2 cm in greatest dimension
• Shape:	Oval
• Margins:	Circumscribed
• Density:	Equal
‣ Calcifications:
• Typically benign:	Coarse (right), popcorn-like (left)
• Suspicious:	None
• Distribution:	In mass
‣ Architectural distortion:	None
‣ Asymmetry:	None
‣ Intramammary node:	None
‣ Skin lesion:	None
‣ Solitary dilated duct:	None
‣ Associated features:	None

BI-RADS:

BI-RADS Category: 2 (benign)

Case summary:

Premenopausal woman presented with bilateral mastalgia. Diagnosed as involuting (partially calcified) fibroadenoma in both breasts, BI-RADS 2 on imaging.

Learning points:

Involuting fibroadenomas show typically benign coarse or popcorn-like macrocalcification. No further assessment is needed.