A 17yo girl with a lump in her breast was seen in the clinic. Exam: the lump was free and mobile and not attached to the skin. Her mother wants further tests
done. What should be the next step?
b. US breast
c. Punch biopsy
d. Reassure and send home
e. Stereotactic biopsy
Clincher(s) 17yo girl, lump was free and mobile and not attached to the skin.
KEY: B US
Triple assesment for breast lump
• clinical examination
• imaging :mamography if older than 35 years or u/s for younger patients
This is a benign tumour that is common in young women, mostly aged under
40 years. They are the most common tumour of the breast in those under 30
years old, but overall they are second to breast cancer. Assessment often
includes examination, imaging studies and fine-needle aspiration. Ultrasound
in younger women with dense breasts, as mammograms are more difficult
to interpret in this group. Routine mammography, as a population screening
tool, is not performed below the age of 50 years.
• The initial examination depends upon the age of the patient.
Ultrasound for <35 years old; Mammography and then Ultrasound for
35 years old.
• Ultrasound is best for dense breast tissue, whereas Mammography is
best for less dense breast tissue; eg, after menopause. • CT is not done for breast lesions.
• Stereotactic Biopsy is the investigation of choice only when there are
no palpable masses.