A 56-year-old woman undergoes screening mammography, which reveals a cluster of pleomorphic microcalcifications in the left breast with no associated mass or architectural distortion. Palpation of both breasts is normal. What is the most appropriate next step?
- A Fine-needle aspiration cytology of the area
- B Stereotactic core needle biopsy ✓
- C Wide local excision of the quadrant
- D Repeat mammography after six months
Correct answer: B. Stereotactic core needle biopsy
Explanation
Pleomorphic microcalcifications are suspicious for DCIS or invasive carcinoma, and tissue diagnosis is mandatory. Because the lesion is impalpable and visible only on mammography, stereotactic guidance allows accurate core needle biopsy, which is the standard diagnostic procedure. Fine-needle aspiration cannot assess architecture and is unreliable for calcified lesions. Immediate therapeutic excision before diagnosis is inappropriate, and six-month repeat mammography would delay treatment of a potentially malignant lesion.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.