tailieunhanh - Case lâm sàng sản khoa - Case 8

Tham khảo tài liệu 'case lâm sàng sản khoa - case 8', y tế - sức khoẻ, y dược phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | CASE 26 A I -cm breast mass is discovered during a routine physical examination of a 22-year-old woman. She has no family history of breast cancer. She denies breast leakage or prior irradiation. On examination her BP is 100 60. I ler physical examination is unremarkable except for the breast mass. 1 ler neck is supple and the heart and lung examinations are normal. Palpation of her right breast reveals a firm mobile nontender rubbery 1-cm mass in the upper outer quadrant. No adenopathy is noted. The left breast is normal to palpation. What is your next step What is the most likely diagnosis 220 case FILES OBSTETRICS AND GYNECOLOGY ANSWERS TO CASE 26 Fibroadenoma of the Breast Summary A 22-year-old woman is noted to have a 1-cm breast mass on routine physical examination. Palpation of her right breast reveals a firm mobile nontender rubbery I-cm mass in the upper outer quadrant. No adenopathy is noted. Next step Biopsy of the mass fine needle biopsy . Most likely diagnosis Fibroadenoma of the breast. Analysis Objectives 1. Understand that any three-dimensional dominant mass needs a biopsy. 2. Know the characteristic presentation of fibroadenomas of the breast. 3. Understand that the greater the risk of breast cancer the more tissue that is needed for biopsy. Considerations This woman is young and has a dominant breast mass. The firm nontender rubbery description is classic for a fibroadenoma. Fibroadenomas as opposed to fibrocystic changes do not change with the menstrual cycle. Although the most likely diagnosis is a fibroadenoma this diagnosis needs to be confirmed by biopsy. A fine needle aspiration FNA is acceptable since the patient is at low risk for breast cancer. She has no family history of breast cancer is of a young age and her examination does not contain any worrisome features of breast cancer. If the mass were fixed or if there were nipple retraction or bloody nipple discharge the better method of biopsy would be excisional biopsy to remove the entire