A-aspiration
B-repeat US in 6 mo
FAD on US
C-US core biopsy-
No, since this likely fibroadenoma has no malignant features, tissue sampling with US core is not indicated unless the patient has a very strong family history of breast cancer, which she does not. US core is not needed for simple cysts.
A-aspiration:
No, incidentally found simple cysts are extremely common in women < age 30 and fine needle aspiration of an asymptomatic simple cyst would be inappropriate. Aspiration of the probable fibroadenoma is also not indicated.
OB GYN CASE 1-IMAGES
simple cyst on US
very dense MG
What would you do next?
C-US core biopsy
D-excision
set up each as a link with answer B correct
D-excision
No, it would only be appropriate to consider excision of a fibroadenoma if it were extremely painful or large enough to be cosmetically an issue for the patient. There is no indication for removal of simple cysts unless they are very large and painful.
B-repeat US in 6 mo:
Yes, the ACR recommends short-term follow up of presumed fibroadenomas (or any other BIRADS 3 lesion) with repeat US right breast in 6 months-no followup is needed for the cyst.
Ms. Smith has calmed down after your explanation of the best next steps and has scheduled an appointment to see you in 6 months