A 35-year-old woman presents with a smooth, mobile, rubbery 1.5 cm lump in the left breast. Fine-needle aspiration cytology (FNAC) shows a benign epithelial lesion with biphasic pattern. USS shows a well-defined homogeneous hypoechoic lesion. She is anxious about malignancy. What is the most likely diagnosis and what is the appropriate management?
- A Phyllodes tumour; wide local excision with 1 cm margins
- B Breast cyst; aspiration
- C Fibroadenoma; reassurance and annual clinical review ✓
- D Invasive lobular carcinoma; mastectomy
Correct answer: C. Fibroadenoma; reassurance and annual clinical review
Explanation
A smooth, mobile, rubbery lump in a young woman with benign FNAC showing a biphasic (epithelial and stromal) pattern on a well-defined USS lesion is characteristic of a fibroadenoma. In women under 40 with a lesion less than 3 cm and confirmed benign triple assessment, conservative management with reassurance and clinical/USS review is appropriate; most fibroadenomas involute spontaneously. Phyllodes tumour is typically larger, faster-growing, and requires excision. A cyst would be anechoic on USS. Lobular carcinoma would show malignant cytology.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.