A 25-year-old woman presents with a 2-week history of a mass in the upper outer quadrant of her right breast. On examination she has a mobile firm mas

Subject
Obstetrics and Gynaecology
System
Female Reproductive System & Breasts

DianaZ

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A 25-year-old woman presents with a 2-week history of a mass in the upper outer quadrant of her right breast. On examination she has a mobile firm mass, ovoid in shape and measuring 3 x 1.5 cm with a lobulated surface. There are no palpable axillary lymph nodes. Ultrasound examination suggests the lesion to be a fibroadenoma but some atypical features are present. Which of the following would be the most appropriate investigation to perform next?

A. Core needle biopsy
B. Excision biopsy
C. Fine needle aspiration cytology
D. Magnetic resonance imaging
E. Mammography

Explanatory Notes:
Core needle biopsy is required for a histological diagnosis as the lesion may be a phyllodes tumour rather than a simple fibroadenoma.
Fine needle aspiration cytology is much less accurate than core needle biopsy. Excision biopsy should not be performed without attempting a preoperative diagnosis, as a second operative procedure might be required. Mammography would not be routinely performed in a patient of 25 years due to the hazards associated with exposure to ionising radiation. Magnetic resonance imaging would not be indicated as it is unlikely to help gain a definitive diagnosis
 
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