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  #1  
Old 04-22-2011
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Question management of breast mass

A 32 years old woman reports that she feels a mass in her right breast. A 2 cm by 3 cm mass is palpable in the outer right lower quadrant of the breast. There are no associated skin changes and the mass has limited mobility. There is a small amount of blood stained discharge from the nipple. One axillary lymph node was palpable on the right side.

Which of the following is the most appropriate next step in the management of this patient?
A. Observation for one year and repeat the mammography
B. Conduct a needle-guided biopsy of the breast
C. Confirm findings with ultrasonography of the breast
D. Recommend an excision biopsy of the breast
E. Partial mastectomy
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The above post was thanked by:
ashishkabir (04-23-2011)



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Old 04-23-2011
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I'm left with 2 good answers: either B or D!

What's the diagnosis here? Are we thinking about malignancy? Yes-likely!

Let's wait what others think!

Thanks seetal for posting good cases!
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Old 04-23-2011
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I'd say B. Conduct a needle-guided biopsy of the breast.

There are signs of potential malignancy here, and so definite diagnosis is needed before proceeding to further management. Excisional biopsy is not appropriate at this point.
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Old 04-23-2011
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I agree with Haisook, but isn't the mass too big? I believe that masses more than 2cm require excision instead of needle biopsy is that correct?

http://www.medscape.com/viewarticle/408932_6
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  #5  
Old 04-23-2011
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yes i was thinking excision biopsy too. sorry for posting questions i have no answers too. but what better way for me to be sure of the answers i pick?
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Old 04-23-2011
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guys " excisional biopsy".... let the histopathology decide what it was....100% " excisional biopsy"
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  #7  
Old 04-23-2011
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Default ???

blood- 32 year old female? Intraductal papiloma no? is that cancer?
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Old 04-23-2011
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Having solitary intraductal papillomas does not increase your risk for breast cancer, unless they are composed of other conditions, such as atypical hyperplasia. If you have multiple papillomas or papillomatosis, your risk for developing breast cancer is slightly increased... I would do a galactogram or us to search for more lesions b4 I biopsy it in a young female without family history.
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  #9  
Old 04-23-2011
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Default Ohh

didnt notice the node involvment! Yep biopsy D
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