A 28-year-old woman presents with a 2.5 cm well-circumscribed, rubbery, freely mobile breast lump that has slowly enlarged over 18 months. Ultrasound shows a solid, homogeneous, hypoechoic mass with smooth margins. Core biopsy shows biphasic proliferation of glandular and stromal elements with no atypia. What is the most appropriate management?
- A Simple enucleation or excision with cosmetic closure ✓
- B Wide local excision with 1 cm margins
- C Sentinel lymph node biopsy with axillary clearance
- D Neoadjuvant chemotherapy followed by mastectomy
Correct answer: A. Simple enucleation or excision with cosmetic closure
Explanation
The findings describe a fibroadenoma, a benign biphasic tumor. Simple enucleation or local excision is curative. Wide local excision with margins is indicated for phyllodes tumors, not fibroadenomas. Sentinel node biopsy is unnecessary as fibroadenomas are benign and do not metastasize to axillary nodes. Neoadjuvant chemotherapy is indicated only for malignant neoplasms.
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.