Breast Surgery 🍈

A 34-year-old woman experiences occasional discomfort in the top exterior portion of her left mammary gland that extends to her underarm. The discomfort is characterized as a sharp, piercing sensation. During the examination, there were no noticeable lumps or palpable lymph nodes. What is the MOST probable diagnosis?

A woman, now 39 years old, underwent a right mastectomy and axillary lymph node removal due to primary breast angiosarcoma approximately 7 years prior. She also received chemo and radiation therapy to treat her cancer. She now visits the breast clinic, citing a recent emergence of violet-hued nodules on her right chest that she first noticed about a month and a half ago. Over the past few weeks, she has seen the nodule grow and discoloration around it intensify. Clinical examination reveals an irregularly shaped violet nodule with an encircling purple-blue pigmentation of unclear boundaries. The nodule’s dimensions are 0.9 by 1.1 cm. A biopsy was performed. What is the MOST probable tissue diagnosis?

A 69-year-old woman comes forward with a hard, spherical, non-tender 5cm mass in her right mammary gland. There’s a contusion evident on the surface, with no discharge present. What is the SINGLE most probable diagnosis?

A 43-year-old woman consults her primary care physician, expressing worry about the risk of breast cancer. Her family history is notable, with her grandmother succumbing to breast cancer, her mother having undergone a right mastectomy the previous year, and her sister diagnosed with breast cancer at 38 and now in remission. Genetic testing, motivated by her family history, revealed the presence of the BRCA1 gene mutation in this patient. She had a mammogram six months prior, which showed no abnormalities. Examination of the breast shows no skin changes, no changes in the nipple, and no detectable masses. However, a 1 cm by 1 cm, smooth and non-tender lymph node was discovered in her left armpit. What is the SINGLE most suitable next course of action for this patient?

A 66-year-old woman has undergone treatment for breast cancer with tamoxifen. What SINGLE medication should be introduced into her treatment regimen?

A 31-year-old woman reports a single 2 cm by 2 cm lump in her breast. The lump is moveable and hard to the touch. Upon examination, the mass is painless, and a palpable lymph node is found in the axilla. An ultrasound reveals a mass with hypoechoic, ill-defined, spiculated, and microlobulated margins. A mammogram indicates ill-defined, spiculate borders. Fine needle aspiration cytology was performed, but the results came back as normal. What is the SINGLE most appropriate investigation to verify the diagnosis?

A 31-year-old woman has experienced bilateral breast discomfort for the past half a year. The pain begins two weeks prior to her menstrual cycle and eases after menstruation. She characterizes the pain as a dull, achy sensation. She is on combined oral contraceptive pills. During examination, no palpable lumps or skin discolouration are detected. She consumes a cup of tea each morning. What is the SINGLE most appropriate course of action?

A 52-year-old woman, who was previously treated for breast cancer three years ago, now complains of increased thirst and confusion. She has become significantly drowsy of late. She has been experiencing pain in her left shoulder for several months. An abnormal blood test result was recently reported. What is the SINGLE most probable metabolic abnormality?

A woman aged 26 comes in, reporting a 1 cm, firm, mobile, and smooth lump in her left breast that’s causing her some discomfort. She’s extremely worried and desires an evaluation. Which SINGLE investigation method is the most suitable?

A 30-year-old expectant woman, currently at 30 weeks gestation, sustained a mild chest injury due to direct trauma from her seat belt during a car accident about three weeks ago. She now has a painless, firm mass under her left nipple with noticeable dimpling. What is the SINGLE most probable diagnosis?

A 29-year-old woman comes in for a regular annual check-up at her general practitioner’s office. She mentions a lump in her breast that she’s had for two years but has not sought medical attention for. The lump has remained consistent in size over the past two years. Upon examination, a firm 3 cm by 2 cm mass is found in the right upper outer quadrant of her breast. The mass is not painful and can be easily moved. What is the SINGLE most probable diagnosis?

A 30-year-old woman visits a breast clinic, concerned about a lump in her left breast that she’s noticed for the past month. Upon examination, two smooth, regular, firm, and movable lumps are found in the upper outer quadrant of her left breast. The lumps are not causing her any discomfort and both measure 2 cm by 2 cm. Her most recent menstrual period was two weeks prior. It’s also noteworthy that her mother had been diagnosed with breast cancer. What is the SINGLE most probable diagnosis?

A 37-year-old woman comes to her GP’s office, concerned about a lump she’s discovered in her left breast. She first detected the mass about two weeks ago while showering, and she hasn’t paid attention to whether its appearance fluctuates with her menstrual cycle. She has no significant past medical history and is not on any long-term medications. Further inquiry reveals no additional complaints such as night sweats, weight loss, or fever, and this is the first time she’s noticed a breast mass. There’s no family history of breast cancer. Upon physical examination, a 2.5 cm by 1.5 cm mass is found in the left lower quadrant of her left breast. The mass is regular, firm, non-tender, and mobile. The skin over her left nipple looks normal, and there’s no nipple discharge. The remainder of the breast exam is unremarkable, with no enlarged lymph nodes detected in her neck or axillary region. Her right breast appears normal. She subsequently undergoes fine needle aspiration cytology (FNAC), which reveals duct-like epithelium surrounded by fibrous bridging. What is the SINGLE most probable diagnosis?

A 39-year-old woman presents at the breast clinic due to a lump she’s detected in her right breast. There’s redness around the areola, and a palpable lump is present behind the nipple, causing her breast to feel warm and tender. However, she’s not running a fever. A heavy smoker since her teen years, she’s experienced a similar episode in the past that was resolved with oral antibiotics. A fine needle aspiration procures about 1 ml of green discharge. What is the SINGLE most probable diagnosis?

A 35-year-old lady has been diagnosed with a hormone receptor-positive, early-stage breast cancer in her left breast. The tumour measures 10 mm in diameter and there are no signs of metastatic spread. She is scheduled for a left mastectomy. During pre-assessment, it was discovered that she is in her 6th week of pregnancy and she has no other significant medical history. What is the most suitable course of action?

A 46-year-old woman with a medical history of breast cancer, for which she underwent a mastectomy on the left side along with an ipsilateral axillary lymph node removal 2 years prior, consults her primary care physician with a concern about swelling in her left upper arm that has been present for the last three days. Apart from a small insect bite observed on the anterior part of her left upper arm, her physical examination doesn’t show anything out of the ordinary. What is the most probable cause behind the swelling in the patient’s upper limb?

A 64 year old woman presents to the breast clinic after noticing a blood-stained discharge from her left nipple. She also experiences dry skin over the left areola, resembling eczema. During the examination, the left areola exhibits a blood-stained discharge along with dry, flaky skin, and the nipple appears ulcerated. Which investigation is the MOST SUITABLE in this case?

A 40-year-old woman who smokes has been noticing a thick, creamy, brown discharge from her left nipple for the past two weeks. She has also been experiencing pain in her left breast for several months. Upon examination, a palpable subareolar mass with nipple retraction is noticed on her left breast. No palpable lymph nodes are present. Her body temperature is 37.1°C. What is the most probable diagnosis?

A 51-year-old woman with a history of breast cancer, who had a mastectomy on her left side along with ipsilateral axillary lymph node removal two years prior, visits her general practitioner. She has been experiencing swelling in her left upper limb for the past two weeks and reports a feeling of tightness in her hand. She suffered an insect bite on her left hand a month ago. She does not have a rash and is not complaining of itching. She does not have a fever. What is the most likely explanation for her swelling?

A 37-year-old woman has been experiencing painless bleeding from her left nipple over the last two days. No lump can be felt in the breast and there are no visible changes to the skin of the breast. What is the most probable diagnosis?

A 69-year-old woman had a radical mastectomy. She now presents with swelling and redness in her right upper limb. Which of the following structures, if removed during surgery, could lead to these symptoms?

A 60-year-old lady comes in with a complaint of a sore nipple and a rash around the areola. She reports a progressively worsening, itchy rash on her nipple. Over the past few months, she has been having a clear fluid discharge from her left nipple, which has recently had a small amount of blood in it. Upon examination, her left nipple is dry, cracked, and surrounded by a scaly, reddish area. Her right nipple appears normal and no lymphadenopathy is present. A mammogram conducted 3 years ago was normal. What is the most probable diagnosis?

A 52-year-old lady comes in with a one-sided painful nipple. It’s been itchy. She hasn’t seen any discharge. Over the recent months, she’s observed alterations to her nipple. An image of the nipple is presented below:

What is the SINGLE most probable diagnosis?

A 55-year-old woman underwent testing, including a biopsy, after discovering a breast lump and related skin changes that made the skin appear reddish and dimpled. The biopsy suggested the presence of cancer. What is the SINGLE most probable description of the histopathological results?

A 28-year-old lady has been experiencing breast discomfort for the previous 3 months. The discomfort is equally distributed on both breasts. She has been on combined oral contraceptives for the last 20 months. She notices the pain intensifying a few days before her menstruation starts, but it diminishes after the end of her menstrual cycle. She reports a generalized swelling in both breasts. Upon examination, there are no discernible lumps or skin discoloration. What is the SINGLE most suitable course of action?

A 48-year-old woman has been experiencing a foul-smelling yellow discharge from the left nipple area over the past several days. She had a subareolar abscess six months ago which was surgically treated. No abnormal skin changes on the breast or palpable lumps are present. What is the SINGLE most probable diagnosis?

A 33-year-old woman has had a 4 cm breast lump removed from the upper outer quadrant of her left breast. The histology report reads:

“Well defined and unencapsulated with clear margins and separate from the surrounding fatty tissue. There are overgrowths of fibrous and glandular tissue. There is a slight degree of stromal cellularity and overgrowth”

What is the SINGLE most probable interpretation of this report?

A 40-year-old woman is experiencing itchiness around the breast and a greenish, foul-smelling discharge from the nipple. She had a similar episode about a year ago. What is the SINGLE most probable diagnosis?

A 52-year-old man underwent surgery for cancer in his left breast. The mass was successfully removed surgically, ensuring safety margins, no penetration, and no lymph node metastasis. What is the optimal supplementary therapy to provide?

A 31 year old woman visits the breast clinic with a 5-week history of inflammation around her right areola. There is minor nipple retraction at the site and a small palpable lump at the base of the nipple. The area around her areola is tender to touch. She has a greenish discharge from the nipple. Her past medical history includes smoking 10 cigarettes a day for the past decade. She was assessed in the breast clinic and given flucloxacillin, which improved her condition. What is the SINGLE most likely diagnosis?

A 53-year-old woman consults her GP about a 2 cm small, smooth, firm lump in her left breast that she discovered two weeks ago. The lump is non-tender and there are no signs of nipple discharge or retraction. She has no family history of breast cancer, doesn’t smoke, and doesn’t have any other health issues. She had a mammogram two months prior which showed satisfactory results. There are no associated skin changes in the breast. The lump is slightly mobile upon examination. What is the SINGLE most appropriate next step in management?

A 29-year-old woman has been experiencing breast tenderness for the past 3 months. The tenderness is bilateral, but it is more severe on the left side. The pain seems to worsen a few days before her menstrual cycle begins and eases after her cycle ends. She also notes generalized swelling throughout both breasts. Upon examination, there are no palpable lumps. What is the SINGLE most appropriate action?