Instructions: Listen to the podcast episode available below, and then submit your answers to the multiple choice questions. You will review the answers and the material covered during your next Continuity Clinic Session.
Benign Breast Disease
1. A 54 yo menopausal woman comes to the office with 2 weeks of spontaneous blood nipple discharge. On exam, you note no palpable masses. She has no tenderness. You see no retraction or dimpling of the breast. The nipple is in normal position. There are no skin changes. You find no palpable lymph nodes. Circumferential palpation around the areola elicits a bloody discharge from a single ductal orifice. Diagnostic mammography is negative for malignancy. What is the most likely diagnosis?
2. A 24 yo G2P2 who is 3 weeks postpartum presented 4 days ago with fever, chills and left breast pain. Mastitis was diagnosed. She received oral dicloxacillin. Today, she reports continued fever and worsening left breast pain. On exam, a 4 cm fluctuant area of induction, erythema and warmth is noted. What is the next best step in management?
3. A 47 yo woman presents for routine bilateral screening mammography. She is found to have fibrocystic changes and a small mass that, on biopsy, is consistent with ductal hyperplasia without atypia. What is the most appropriate next step?