A 36-year-old woman comes to the physician because of progressively worsening painful swelling of both breasts for the past 24 hours. Three days ago, she vaginally delivered a healthy 2690-g (5-lb 15-oz) girl. The patient says that breastfeeding her newborn daughter is very painful. She reports exhaustion and moodiness. She has no history of serious illness. Medications include folic acid and a multivitamin. Her temperature is 37.4°C (99.3°F). Examination shows tenderness, firmness, and fullness of both breasts. The nipples appear cracked and the areolas are swollen bilaterally. Which of the following is the most appropriate next step in management?
AOral antibiotics
BCold compresses and analgesia
COral contraceptives
DMammography
EIncision and drainage
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
A 32-year-old woman presents to her physician concerned about wet spots on the inside part of her dress shirts, which she thinks may be coming from one of her breasts. She states that it is painless and that the discharge is usually blood-tinged. She denies any history of malignancy in her family and states that she has been having regular periods since they first started at age 13. She does not have any children. The patient has normal vitals and denies any cough, fever. On exam, there are no palpable masses, and the patient does not have any erythema or induration. What is the most likely diagnosis?
AIntraductal papilloma
BDuctal carcinoma
CPaget's disease
DBreast abscess
EFibrocystic changes
+ 7 more in the PDF
Browse all chapters