MCQ Surgery Answer 9

The correct answer is D.

Breast lumps are a common complaint in women. Many of these masses are benign processes. Benign conditions of the breast include fibrocystic disease, fibroadenomas, galactoceles, abscesses, and necrosis. It is appropriate to aspirate a palpable macrocyst in the breast; the fluid should be placed on a slide and sent for cytologic evaluation. If the cytology is negative, no further treatment is needed. Some would argue that if the cyst recurs, it may be aspirated again. However, when a lesion recurs twice, as has occurred in this patient, open biopsy is warranted.

To wait to perform mammography in 1 year (choice A) or ultrasound in 1 year (choice B) would be incorrect management. First, if a malignancy is present, waiting another year will allow progression of the cancer. Second, the mammogram is not definitive. Imaging can contribute information to the workup of a breast mass, but the definitive diagnosis rests on histologic evaluation.

Tamoxifen therapy (choice C) is used to both prevent and treat breast cancer. However, this patient does not yet have a diagnosis. She has a cystic mass that has been aspirated twice and has recurred twice. She therefore requires a biopsy to establish a diagnosis prior to the institution of any treatment.

Mastectomy (choice E) would not be indicated for this patient. Again, this patient does not have a diagnosis, and to perform a mastectomy for a recurrent cyst would be inappropriate.

Category: Surgery MCQs