A 34-year-old woman presents with a smooth, mobile, 3 cm lump in the left breast of two weeks' duration. Ultrasound confirms a simple cyst. Aspiration yields clear greenish fluid and the lump disappears completely. What is the most appropriate next step?
- A Excision biopsy of the cyst wall
- B Core needle biopsy of the cavity wall
- C Reassurance and clinical review if the lump recurs ✓
- D Start tamoxifen for six months
Correct answer: C. Reassurance and clinical review if the lump recurs
Explanation
A discrete breast cyst that vanishes completely after aspiration of non-bloody fluid needs no further intervention beyond reassurance and routine review. Excision is reserved for cysts that recur repeatedly after aspiration, contain blood-stained fluid, or leave a residual palpable mass, because those features raise concern for an underlying intracystic tumour such as papillary carcinoma. Clear fluid cytology is unnecessary.
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.