TRIPLE ASSESSMENTS FOR BREAST LUMP
- Clinical examination of the breast including axillary lymph nodes
- If the lump is mobile, not attached to underlying structure, firm in consistence, smooth surface: It’s likely to be fibroadenoma, especially in young patient.
- If non-mobile lump, hard in consistency, attached to the underlying structure, irregular surface: It’s likely to be carcinoma.
- If there are lumps int he axilla it means carcinoma because that is a sign of metastasis.
- If there is no palpable masses the investigation of choice is stereotactic biopsy.
- If woman is <35 years : Perform USS only
- If woman is 35 years or above: Do mammography first and then USS
- In either case, you have done USS which will differentiate whether the lump is cystic or solid. If cystic, perform FNAC. Further management depends upon the type of fluid aspirated:
- If aspirate is a clear fluid: Just aspirate and reassure the patient.
- If blood stained: send the aspirate to lab for cytology.
- If clear fluid but residual mass, perform core biopsy.
- If the lump is solid, perform core biopsy.
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