Yes, it is a nightmare!
I speak to the radiologist and ask them what they would like.
Sometimes they ask me to measure the longest axis of each one and document them all giving o’clock location and distance from the nipple. I find this approach tedious.
What I prefer is the radiologist to ask me to measure and document the largest few and survey all other fibroadenomas for suspicious characteristic such as angular margins, vertical orientation etc. I think this is a more logical approach.
The bottom line for me is to consult the radiologist and provide whatever documentation they are seeking.