DrVirgo
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43. A 55 year old woman has persistent unilateral, bloody nipple discharge. Microcalcifications 3cm below the nipple of the left breast are seen on mammography. Which of the following is the most appropriate next step in management?
A. CT scan of the breast and axillary nodes
B. Cytologic exam of the discharge
C. Needle aspiration under ultrasound guidance
D. Open biopsy of the breast in an outpatient setting
E. Repeat mammography in 3 months
Explain please.
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| yasmeen
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B?
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| Guptashutosh
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C will be the correct ans , this women most probab has br cancer... we need to confirm it with fnac , and type the tumor to help in mgt
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| Aashi
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Breast mass + discharge shld undergo needle aspiration BX..just simple cytologic ex is not enogh,and this is enough if the breast mass was not there intially..
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| DrVirgo
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Right Answer: D.
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| alpha12
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I'd think that FNA would be in the presence of a mass, and I don't see any in here. So, i'll go with B (cytology)
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| aml
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D
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| rody
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WHY NOT B DRVIRGO
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| mammyQ
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I pick B, found it in Obgyn blue prints
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| ed222
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bloody nipple discharge, microcalcifications are highly indicative of breast cancer. It doesn't said anything about mass, mass size, axillary nodes or anything else. I think FNA is the step to take now then examine the type of cancer cells, metastasis, etc. FNA and more examinations will tell us to go to open biopsy, mastectomy or chemo and radiation if it is spread.
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