Breast cancer — MCCQE Part 1 MCQ

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ModerateBreast LumpBreast cancerMCCQE Part 1

52-year-old woman presents with a firm breast lump. It is irregular, fixed and associated with skin dimpling. Which of the following is the most appropriate next step?

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Correct answer: B — Arrange diagnostic mammography/ultrasound and core biopsy

Arrange diagnostic mammography/ultrasound and core biopsy is best because a suspicious palpable mass needs triple assessment. Discharge with oral analgesia only is suboptimal because analgesia alone may mask a surgical emergency; Delay surgical assessment until routine clinic is suboptimal because time-sensitive surgical presentations require urgent assessment; Treat with laxatives or antacids as sole therapy is suboptimal because a benign gastrointestinal explanation does not account for the red flags; Perform an invasive bedside procedure without imaging or senior input is suboptimal because invasive treatment can worsen outcomes when anatomy or diagnosis is uncertain. Screening rules do not replace diagnostic work-up for a symptomatic lump.

Reference: Canadian Association of Radiologists/SOGC breast guidance