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  #1  
Old 08-10-2013
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Default Breast mass

1.A 55-year-old woman has a palpable 2 cm mass in her left breast. She had found the mass on self-examination, but she says that she had not done self-breast exam for at least six months before she did this one. Physical examination confirms the presence of the lesion, which is hard, movable, and not painful. A mammogram confirms the presence of an opacity in that area, but it does not have any of the radiological characteristics of a breast cancer. The radiologist also does a sonogram, and comes up with the same opinion, i.e., that neither study is suggestive for cancer. Fine needle aspirate is read as negative. Which of the following is the most appropriate next step in management?

A. Core biopsies of the mass

B. MRI of the breast

C. Reassurance

D. Repeat both imaging studies in six months

E. Repeat physical exam in six months
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Old 08-11-2013
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A. Core biopsy is the best next step.
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Old 08-11-2013
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Ans A ..........
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Old 08-11-2013
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ofcourse A.....
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Old 08-11-2013
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A 100 %!...
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Old 08-11-2013
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Answer is A stereotactic excisional biopsy... The gross characteristics are suspicious for malignancy, and her age is like the worst risk factor. It doesnt matter what the radiologist or whoever say, she needs that thing out ASAP!
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Old 08-11-2013
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Yeah...the answer is A...It somehow dint seem so obvious to me
Will someone answer the question on pharyngitis I put up the other day too?
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Old 08-12-2013
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Quote:
Originally Posted by BigFatPanda View Post
Yeah...the answer is A...It somehow dint seem so obvious to me
Will someone answer the question on pharyngitis I put up the other day too?
in a 55 y/o female you can never exclude cancer by images alone. Once you find a mass in this age group the mamogram is done only to see if there are other lesions. THere is no FNA here you have to go straight to core biopsy because only with core biopsy can you determine if the cancer is ER or PR positive and that gives you an outlook on management. Hope it helped i took a shot at it
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Old 08-13-2013
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Quote:
Originally Posted by Kais_MD View Post
in a 55 y/o female you can never exclude cancer by images alone. Once you find a mass in this age group the mamogram is done only to see if there are other lesions. THere is no FNA here you have to go straight to core biopsy because only with core biopsy can you determine if the cancer is ER or PR positive and that gives you an outlook on management. Hope it helped i took a shot at it
This is correct core biopsy is superior to FNB

patients over 30 get a mammogram followed by a core biopsy, if postive ER/PR receptor plus HER2/neu testing, if positive sentinel node biopsy

I think thats it for testing of breast cancer.
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