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Old 12-02-2011
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Question Breast mass and non-diagnostic mammogram!

A 35-year-old woman comes to the clinic because of a left breast “thickness.” She noted this 5 months ago and it has not receded. She has no family history of breast cancer. There is no drainage. She denies any pain. She has no other medical issues. She takes no birth control pills or any other medication. Examination shows a palpable mass in the left breast at 9 o’clock. A mammogram is nondiagnostic. Which of the following is the appropriate course of action?

A. Observe and repeat mammogram in 1 month
B. Prescribe hormone replacement therapy
C. Schedule breast ultrasound
D. Schedule a lumpectomy
E. Schedule a mastectomy
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Old 12-02-2011
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C. Schedule breast ultrasound
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Old 12-02-2011
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C. Schedule breast ultrasound
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Old 12-03-2011
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C. Schedule breast ultrasound
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Old 12-03-2011
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c ultrasound for sure
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Old 12-03-2011
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C. USG as mammogram is non-Diagnostic and so we should move 1 step further in Ix
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Old 12-04-2011
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The correct answer is C. This patient should undergo ultrasonography of the breast to distinguish pure cysts from solid or mixed lesions, or she should have a tissue diagnosis. The tissue diagnosis can be performed by fine-needle aspiration, core needle biopsy, or excisional biopsy.
If a patient first presents with a breast lump, re-examination based on the follicular phase of the menstrual cycle would be appropriate (choice A). This patient has had the mass for several months, however.
Fibroadenomas may vary with the menstrual cycle. Prescribing hormones without the appropriate workup is not advisable, however (choice B).
If the aspiration shows malignant cells, the patient would need a lumpectomy (choice D).
Based on the results of the ultrasound, the patient may need a biopsy. Mastectomy at this time, before the workup is complete, is inappropriate (choice E).
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