A 49-year-old woman presents to her physician with complaints of breast swelling and redness of the skin over her right breast for the past 1 month. She also mentions that the skin above her right breast appears to have thickened. She denies any pain or nipple discharge. The past medical history is significant for a total abdominal hysterectomy at 45 years of age. Her last mammogram 1 year ago was negative for any pathologic changes. On examination, the right breast was diffusely erythematous with gross edema and tenderness and appeared larger than the left breast. The right nipple was retracted and the right breast was warmer than the left breast. No localized mass was palpated. Which of the following statements best describes the patient’s most likely condition?
AIt shows predominant lymphatic spread.
BThe lesion expresses receptors for estrogen and progesterone.
CThe lesion is due to Streptococcal infection.
DIt is a benign lesion.
EThe inflammation is due to obstruction of dermal lymphatic vessels.
A 52-year-old woman visits your office complaining about discharge from her left nipple for the past 3 months. The discharge looks like gray greenish and its amount is progressively increasing. She appears to be anxious and extremely uncomfortable with this situation as it is embarrassing for her when it occurs outdoors. Past medical history is insignificant. Her family history is negative for breast and ovarian disorders. She tries to stay active by running for 30 minutes every day on a treadmill, staying away from smoking, and by eating a balanced diet. She drinks alcohol occasionally. During physical examination you find a firm, stable mass under an inverted nipple in her left breast; while on the right breast, dilated subareolar ducts can be noted. There is no lymphadenopathy and remaining of the physical exam is normal. A mammogram is performed which reveals tubular calcifications. Which of the following is the most likely diagnosis?
ADuct ectasia
BPeriareolar fistula
CIntraductal papilloma
DPeriductal mastitis
EPhyllodes tumor
A 42-year-old woman presents to the physician because of an abnormal breast biopsy report following suspicious findings on breast imaging. Other than being concerned about her report, she feels well. She has no history of any serious illnesses and takes no medications. She does not smoke. She consumes wine 1–2 times per week with dinner. There is no significant family history of breast or ovarian cancer. Vital signs are within normal limits. Physical examination shows no abnormal findings. The biopsy shows lobular carcinoma in situ (LCIS) in the left breast. Which of the following is the most appropriate next step in management?
ACareful observation + routine mammography
BLeft mastectomy + axillary dissection + local irradiation
CLumpectomy + routine screening
DLumpectomy + breast irradiation
EBreast irradiation + tamoxifen
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