[mosallam]

34 ys female patient comes to clinic complains of painless lump in the right breast , with past history of acute breast abscess, during examination there is tenderness in the breast , not enlarged axillary lymph nodes. The patient is diabetic , the case is diagnosed as chronic breast abscess, what is the next step of management?

a-antibiotics and analgesics
b-incision and drainage
c-excision of the lump
d-mammography and ultrasound

 

[khanar]

I think we have to drain it

 

[zaiody]

i think it's c

 

[shahra]

d-mammography and ultrasound

 

[wahaha007]

I agree with Shahra !

 

[khanar]

Why

Can you guys put some explanation as to why we should do mammography and ultrasound?

 

[shahra]

Can you guys put some explanation as to why we should do mammography and ultrasound?

1-''past history of acute breast abscess''so there is a possibility of underlying lesion(nothing in the Q. rules out breast cancer).
2-any surgical intervention will certainly affect our possible mamographic image.
so let's do mamo,as first step.

I hope I am right.if not,let me know,pls.

 

[mosallam]

answer

in usmle question if told you the case is diagnosed , there is no need for other investigations so we exclude mammoghraphy and sonar
also there is no role for antibiotics and analgesics as there is fibrosis separate the organism from the blood but be useful in acute breast abscess .incision and driange is mangement of acute breast abscess once throbbing pain is present, in chronic breast abscess incision and draiange leaves breast mass
so the correct answer is excision of the lump

 

[shahra]

I wasn't aware of that.Thank you for the tip.