Office management of a palpable breast lump with aspiration

Abstract

693Case [The following is a fictitious case based on experience with similar cases.]Debby is a 45-year-old woman with a self-detected palpable breast lump noticed incidentally one week ago. The lump is tender and increasing in size. Her sister was diagnosed with breast cancer at age 48. Debby is terrified that this may be cancer.

Use of simulators to explore specialty recommendation for a palpable breast mass

“…This is consistent with the use of needle aspiration to differentiate between cystic and solid lesions in an office setting. 3,4,7 In addition, there were more practitioners recommending 1-month follow up for Model 1-Superficial mass , which is consistent with an evaluation of a benign mass that may be hormonally regulated. 3,4,7 As with the imaging recommendations, the shift in tissue sampling and follow up recommendations are in line with practitioners suspecting a benign mass for Model 1-Superficial mass and a malignant mass for Model 2-Chest wall mass .…”

“…Surgeons may be more comfortable with core needle biopsies, and therefore, select this as their primary mode for tissue sampling. Additionally, these practice patterns may be reflective of the differences in workup and recommendations in the surgical 20,21 versus medical 3,4,7,22 literatures. The medical literature recommends use of needle aspiration to evaluate a benign breast mass for distinguishing between a solid and cystic lesion.…”

“…1-3 Benign and malignant masses present with a variety of signs and symptoms. The clinical breast examination (CBE) is the first step in evaluating symptomatic breast patients.…”

“…4 Following the CBE, the diagnostic tests selected by the clinician can influence time to diagnosis, diagnostic accuracy, patient anxiety, and time to treatment. 3,5,6 There is a wide range of practitioners that are involved in the evaluation and workup of patients with palpable breast masses, including family medicine, internal medicine, obstetrics and gynecology (OB/GYN), surgery, and radiology. Additionally, there are a wide variety of evaluation protocols for patients presenting with palpable breast masses.…”

Case Report: 31year Old Unmarried Female Patient with Left Breast Swelling

“…Imaging findings of typical simple breast cyst, then no further workup is necessary. Symptomatic large cysts may require aspiration [3]. If such a cyst is aspirated cytological analysis is usually not required unless it contains bloody material.…”