一名29岁的女性因八个月来左乳头后非周期性乳房疼痛在评估期间被推荐进行双侧乳房超声检查。过去6个月，她一直在接受选择性血清素受体抑制剂治疗广泛性焦虑障碍的临床诊断。详细的病史显示患者的母亲和祖母患有乳腺癌。没有体重减轻、食欲减退的病史，也没有任何肠道或膀胱习惯的改变。患者体重超重，身体质量指数为26.8 kg/m2，在一般体格检查中表现焦虑，脉搏增加（102次/分钟），血压正常（118/82 mm Hg）。局部检查显示，双侧乳房、腹壁前端和前臂四个象限都可以触及到多个小而活动的疼痛性病变。进一步询问后，患者报告称她的母亲和一个兄弟也有类似的疼痛性病变。实验室检查显示，血红蛋白水平正常（12.4 g/dL; 正常范围，12-15 g/dL），白细胞总数为每微升9000个细胞 (9 cells × 109/L)（正常范 围，每微升4500-11,000个细胞[4.5-11 cells × 109/L]），差异性白细胞计数正常（74% 中性粒细胞[正常范围，40%-80%]，24% 淋巴细胞 [正常范围，20%-40%]和2% 嗜酸细胞 [正常范围，1%-4%]），红细胞沉降率为5毫米/小时（正常范围，0-29毫米/小时）。结合乳房颜色多普勒超声和剪切波弹性成像，对乳房的代表性病灶进行高频双侧乳房超声检查。相似的病变也在右前臂的皮下层和腹壁前端发现。

A 29-year-old woman was referred for US of bilateral breasts during evaluation for noncyclical mastalgia predominantly in the left breast of 8 months duration. She had been taking selective serotonin receptor inhibitors for the past 6 months for a clinical diagnosis of generalized anxiety disorder. A detailed medical history revealed breast cancer in the patient's mother and grandmother. There was no history of weight loss or appetite loss, nor was there a history of any altered bowel or bladder habits. The patient was overweight, with a body mass index of 26.8 kg/m2, and appeared anxious during the general physical examination, with an increased pulse (102 beats per minute) and normal blood pressure (118/82 mm Hg). Local examination revealed multiple small mobile painful lesions that were palpable in all quadrants of the bilateral breasts, anterior abdominal wall, and forearm. On further questioning, the patient reported similar painful lesions were present in her mother and one brother. Laboratory investigations showed a normal hemoglobin level (12.4 g/dL; normal range, 12-15 g/dL), a total leukocyte count of 9000 cells per microliter (9 cells × 109/L) (normal range, 4500-11 000 cells per microliter [4.5-11 cells × 109/L]), a normal differential leukocyte count (74% neutrophils [normal range, 40%-80%], 24% lymphocytes [normal range, 20%-40%], and 2% eosinophils [normal range, 1%-4%]), and an erythrocyte sedimentation rate of 5 mm per hour (normal range, 0-29 mm per hour). High-frequency US of bilateral breasts was performed in conjunction with Color Doppler US and shear-wave elastography of representative lesions in the breasts. Similar lesions were also found in the subcutaneous plane of the right forearm and the anterior abdominal wall.