weekly question 22/6/2025

[Admin]

A 14-year-old girl presents to your clinic with a palpable, non-tender right breast mass noted for the past 3 weeks. She denies trauma, fever, or nipple discharge. On exam, the mass is firm, mobile, and measures approximately 4 cm in diameter. An ultrasound shows a solid, well-circumscribed lesion with features consistent with a fibroadenoma. She has no family history of breast cancer or known genetic syndromes. What is the most appropriate next step in management?

a Core needle biopsy

b Immediate excisional biopsy without a margin

c Immediate excisional biopsy with a 1 cm margin

d Observation with ultrasound surveillance at 6 and 12 months

 

[Ismailmohamed]

D

 

[Batoolfatima]

D

 

[M Abdelbary]

D

 

[Abd El wahed]

D

 

[Ismail]

D

 

[vbmsj 2024]

D

 

[Haider Ali]

D

 

[dr.osama.aziz.87]

D

 

[Admin]

Correct answer
d Observation with ultrasound surveillance at 6 and 12 months

This patient has a breast mass less than 5 cm in diameter with benign sonographic features and no high-risk history. Current guidelines recommend observation and serial imaging for low-risk fibroadenoma-like lesions of this size. If there is >50% growth on follow-up imaging, if the patient becomes symptomatic, or if patient or family are requesting further intervention, excisional biopsy is acceptable. Clear margins are not necessary unless a lesion is greater than 5 cm in diameter.