breast cancer

A 58-year-old asymptomatic woman undergoes a screening mammogram. The image is shown. Which of the following is the MOST appropriate next step in the management of this patient?

A 72-year-old woman, status post mastectomy, presents with a lesion. What is the MOST appropriate initial diagnostic test?

A 58-year-old woman, otherwise healthy with no significant medical history, undergoes a routine screening mammogram. The report notes a new cluster of pleomorphic microcalcifications in the upper outer quadrant of her left breast, measuring approximately 1.5 cm, classified as BI-RADS 4. Clinical examination reveals no palpable mass or skin changes. She has no family history of breast cancer. What is the most appropriate next step in the management of this finding?

A 62-year-old woman presents for routine mammography. She has no palpable lumps or skin changes. Her previous mammogram two years ago was normal. The current mammogram is shown. What is the MOST appropriate next step in management?

A 45-year-old woman with a suspicious breast mass on mammography undergoes a biopsy, which confirms invasive ductal carcinoma. She is referred to an oncologist for further management. What is the next step in her management?

A 68-year-old woman presents with a persistent, pruritic rash on her chest wall at the site of a previous mastectomy performed 8 years ago for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation. Examination reveals the area shown. What is the MOST appropriate next step in management?

A 72-year-old woman presents with a 6-month history of a non-healing rash on her chest wall at the site of a previous mastectomy performed 10 years prior for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation. Examination reveals the findings shown. What is the MOST appropriate next step in management?

A 55-year-old woman presents for her routine biennial screening mammogram. She denies any breast lumps, pain, or nipple discharge. Her past medical history is notable only for well-controlled hypothyroidism. There is no family history of breast or ovarian cancer. Physical examination reveals no palpable abnormalities. The provided image is a magnified view from the craniocaudal projection of the left breast. Considering the clinical context and the findings demonstrated, what is the most appropriate immediate next step in the management of this patient?

A 70-year-old woman, post-mastectomy, presents with a chronic, pruritic lesion. What is the MOST likely underlying pathophysiology?

A 68-year-old woman presents with a persistent rash on her chest wall at the site of a previous mastectomy performed 8 years ago. She denies pain or itching. What is the MOST appropriate next step in management?

A 62-year-old postmenopausal woman presents to her general practitioner with complaints of severe hot flashes that significantly affect her quality of life. She has a history of breast cancer diagnosed three years ago, which was treated with surgery and chemotherapy. Her cancer was estrogen receptor-positive. She is currently on tamoxifen as part of her ongoing treatment. She is concerned about the use of hormone replacement therapy due to her cancer history. What is the most appropriate management option for her hot flashes?

A 65-year-old woman presents with a chronic, non-healing lesion at the site of her mastectomy scar, performed 7 years ago. She denies pain but reports occasional itching. What is the MOST appropriate next investigation?

A 62-year-old woman presents for her routine mammogram. She has no personal or family history of breast cancer. She denies any breast pain, nipple discharge, or palpable lumps. Clinical breast exam is unremarkable. Review of her prior mammograms shows stable, scattered fibroglandular densities. The current mammogram is shown. What is the MOST appropriate next step in management?

A 68-year-old woman presents to her GP with a 3-month history of a persistent, mildly pruritic skin lesion on her left chest wall. She had a left simple mastectomy for invasive ductal carcinoma 10 years ago, followed by adjuvant therapy. She denies fever, weight loss, or other systemic symptoms. Physical examination reveals the appearance shown. What is the most appropriate initial diagnostic investigation?

A 42-year-old woman, nulliparous, presents to her general practitioner with a palpable lump in her left breast, noticed two weeks ago. She reports some mild, intermittent tenderness associated with the lump, which she initially attributed to her menstrual cycle, but it has persisted. She has no significant family history of breast cancer. On examination, there is a 1.5 cm, firm, mobile lump in the upper outer quadrant. No skin changes or nipple discharge are noted. Axillary nodes are not palpable. She is otherwise well. Which of the following represents the most appropriate initial management step?

A 28-year-old woman presents with a palpable lump in her left breast, noticed two weeks ago. It feels smooth, mobile, and non-tender. No family history of breast cancer. On examination, a 2cm, firm, mobile mass is noted. Considering Australian guidelines for a palpable breast lump in this age group, what is the most appropriate initial investigation?

A 70-year-old woman presents with a lesion on her chest wall at the site of a mastectomy performed 10 years prior. She reports it started as a small area of redness and has slowly enlarged. What is the MOST likely diagnosis?

A 58-year-old woman presents for her scheduled screening mammogram. She reports no breast lumps, pain, or nipple discharge. Her past medical history includes well-controlled hypertension and osteoarthritis. She has no known family history of breast or ovarian cancer. Physical examination reveals no palpable abnormalities in either breast or axillae. The mammogram is performed, and the image provided is a detail from the craniocaudal view of the left breast. Considering the clinical presentation and the findings demonstrated in the provided image, what is the most appropriate immediate next step in the management of this patient?

A 28-year-old woman presents with a palpable lump in her left breast, noticed two weeks ago. It is slightly tender, especially before her period. On examination, it is mobile, firm, and about 2 cm. No skin changes or nipple discharge. What is the most appropriate initial investigation?

A 58-year-old woman presents for her scheduled screening mammogram. She denies any breast lumps, pain, or nipple discharge. She has no family history of breast cancer. Her physical examination is unremarkable. The image provided is a detail from her left craniocaudal view. Considering this finding, what is the most appropriate immediate next step in her clinical management?

A 62-year-old woman attends her routine mammogram. She has no palpable lumps or skin changes. Her previous mammograms have been normal. The provided image is from the current study. Which of the following is the MOST appropriate next step in management?

A 62-year-old woman presents for her routine screening mammogram. She reports no breast symptoms, and physical examination is unremarkable. Her medical history includes well-controlled type 2 diabetes and hyperlipidaemia. She has no family history of breast cancer. The provided image is a magnified view from the craniocaudal projection of the right breast. Considering the clinical context and the findings demonstrated, what is the most appropriate immediate next step in the management of this patient?

A 60-year-old woman with a history of breast cancer, treated with surgery and radiation 5 years ago, presents with new-onset back pain. Imaging reveals lytic lesions in the spine. What is the most likely diagnosis?

A 65-year-old asymptomatic woman undergoes a screening mammogram. The image shows the findings. Her previous mammograms have been unremarkable. What is the MOST appropriate next step in the management of this patient?

A 55-year-old woman with no palpable breast lumps presents for a routine screening mammogram. The image is shown. What is the MOST appropriate next step?

A 42-year-old woman presents with a new, firm, mobile lump in her left breast, noticed two weeks ago. She is otherwise well. What is the most appropriate initial investigation?

A 52-year-old woman presents to her GP with a palpable lump in her right breast. She reports no pain, nipple discharge, or skin changes. She has no family history of breast cancer. On examination, the lump is firm, non-tender, and mobile. There is no axillary lymphadenopathy. What is the most appropriate initial investigation?

A 55-year-old woman undergoes routine screening mammography. She is asymptomatic with no personal or family history of breast cancer. Physical examination is unremarkable. The provided image is a magnified view from the craniocaudal projection of the right breast. Based on the findings demonstrated, what is the most appropriate immediate next step in the management of this patient?

A 62-year-old woman presents for her routine mammogram. She has no personal or family history of breast cancer. She denies any breast pain, nipple discharge, or palpable lumps. Clinical breast exam is unremarkable. Her previous mammograms have been negative. The current mammogram reveals findings as shown in the image. What is the MOST appropriate next step in management?

A 65-year-old woman presents with a several-month history of a slowly enlarging, mildly pruritic skin lesion on her left chest wall. She underwent a simple mastectomy on the left side for invasive ductal carcinoma 8 years ago. She denies systemic symptoms. Physical examination reveals the appearance shown. What is the most appropriate next step in management?

A 35-year-old woman with a family history of BRCA1-associated breast cancer is considering genetic testing. She is asymptomatic and has no personal history of cancer. What is the MOST appropriate initial step in her management?

A 45-year-old woman presents with a palpable lump in her left breast, noticed two weeks ago. She has no family history of breast cancer. On examination, the lump is firm, mobile, and approximately 2 cm. What is the most appropriate initial investigation?

A 55-year-old woman attends for her routine screening mammogram. She has no breast symptoms and no family history of breast cancer. Her physical examination is unremarkable. The mammogram is performed, and a finding is noted in the upper outer quadrant of the left breast, as shown in the image. Based on the appearance of the finding demonstrated in the image, what is the most appropriate next step in her management?

A 35-year-old woman presents with a 2cm, firm, mobile lump in her left breast, noticed two weeks ago. She is otherwise well. What is the most appropriate initial investigation?

A 62-year-old woman presents for a routine follow-up appointment several years after undergoing a simple mastectomy for pT1N0M0 invasive ductal carcinoma of the left breast. She completed adjuvant endocrine therapy and has been well since. During the consultation, she mentions that she has noticed a persistent area of skin change on her left chest wall, near the mastectomy scar, over the past few months. She describes it as occasionally itchy and slightly raised, but denies pain, discharge, or systemic symptoms such as weight loss or fever. Her vital signs are stable, and physical examination reveals no palpable axillary or supraclavicular lymphadenopathy. The appearance of the affected area is shown in the image. Considering the patient's history and the clinical presentation, what is the most appropriate initial diagnostic step?

A 62-year-old woman undergoes routine screening mammography. She is asymptomatic with no relevant family history of breast cancer. Physical examination is unremarkable. The provided image is a detail from her mammogram. Based on the findings demonstrated in the image, what is the most appropriate immediate next step in the management of this patient?

A 68-year-old woman presents to her general practitioner with a persistent, pruritic rash on her chest wall. She reports a history of left mastectomy for invasive ductal carcinoma 8 years ago, followed by adjuvant chemotherapy and radiation therapy. She denies any recent trauma or changes in soaps or detergents. Physical examination reveals the findings shown. A punch biopsy is performed. Which of the following immunohistochemical stains would most likely be positive in this patient's biopsy sample, supporting the suspected diagnosis?

A 58-year-old woman attends a routine mammography screening. She reports no palpable lumps, pain, or nipple discharge. Her family history is unremarkable. The current mammogram reveals new findings compared to her prior images from the last 5 years. The image is shown. What is the MOST appropriate next step?

A 72-year-old woman presents with a persistent, slowly expanding skin lesion on her right chest wall, present for several months. She underwent a right mastectomy for invasive ductal carcinoma 12 years ago. She denies pain, discharge, or systemic symptoms. Physical examination reveals the appearance shown. Considering the patient's history and the clinical finding, which of the following investigations is most appropriate to assess for potential underlying malignancy or systemic involvement?

Mrs. Eleanor Vance, a 62-year-old retired teacher, presents for her routine biennial screening mammogram through the BreastScreen Australia program. She has no personal history of breast disease, and her family history is negative for breast or ovarian cancer in first-degree relatives. She is otherwise healthy, with a history of diet-controlled type 2 diabetes and osteoarthritis managed with paracetamol. She denies any breast pain, lumps, nipple discharge, or skin changes. Her last mammogram two years ago was reported as normal (BIRADS 1). Physical examination of both breasts and axillae is unremarkable. The current screening mammogram is performed. The image provided is a magnified view from the craniocaudal projection of the left breast, specifically highlighting an area that has been flagged for further assessment by the reporting radiologist due to a change from the previous study. Based on the appearance of the abnormality demonstrated in the provided image, which is the most appropriate method for obtaining a tissue diagnosis?

A 68-year-old woman presents with a persistent, pruritic rash on her chest wall at the site of a previous mastectomy performed 8 years ago for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation at that time. Examination reveals the area shown. What is the MOST appropriate next step in management?

A 68-year-old woman presents with a persistent rash following a mastectomy 5 years prior. What is the MOST appropriate next step in management?

A 62-year-old woman presents for a routine follow-up appointment several years after undergoing a simple mastectomy for pT1N0M0 invasive ductal carcinoma of the left breast. She completed adjuvant endocrine therapy and has been well since, reporting no new systemic symptoms such as unexplained weight loss, fatigue, or bone pain. Her last mammogram of the contralateral breast and clinical examination at her previous visit six months ago were unremarkable. During the current consultation, she mentions that she has noticed a persistent area of skin change on her left chest wall, near the mastectomy scar, over the past few months. She describes it as occasionally itchy and slightly raised, but denies pain, discharge, or significant discomfort. Her vital signs are stable (BP 130/80 mmHg, HR 72 bpm, RR 16/min, Temp 36.8°C). Physical examination reveals no palpable axillary or supraclavicular lymphadenopathy. The appearance of the affected area is shown in the image. Considering the patient's history, the duration and nature of the symptoms, and the clinical presentation, what is the most appropriate initial diagnostic step to investigate this new finding?

A 50-year-old woman presents with a newly discovered, firm, mobile lump in her left breast, approximately 2 cm in size. She has no family history of breast cancer. She is post-menopausal. On examination, the lump is palpable in the upper outer quadrant, appears well-defined, and is non-tender. There are no skin changes or nipple discharge. Axillary nodes are not palpable. Considering the Australian guidelines for breast lump assessment, which of the following is the most appropriate initial investigation?

Mrs. Eleanor Vance, a 62-year-old retired teacher, presents for her routine biennial screening mammogram through the BreastScreen Australia program. She has no personal history of breast disease, and her family history is negative for breast or ovarian cancer in first-degree relatives. She is otherwise healthy, with a history of diet-controlled type 2 diabetes and osteoarthritis managed with paracetamol. She denies any breast pain, lumps, nipple discharge, or skin changes. Her last mammogram two years ago was reported as normal (BIRADS 1). Physical examination of both breasts and axillae is unremarkable. The current screening mammogram is performed. The image provided is a magnified view from the craniocaudal projection of the left breast, specifically highlighting an area that has been flagged for further assessment by the reporting radiologist due to a change from the previous study. Based on the clinical presentation, the patient's history, and the specific finding demonstrated in the provided image from her screening mammogram, what is the most appropriate immediate next step in the management pathway for this patient?

A 35-year-old woman with a strong family history of breast cancer (mother and sister diagnosed before age 40) is concerned about her risk. What is the most appropriate genetic testing for this patient?

A 62-year-old woman presents for routine mammography. The image is shown. What is the MOST appropriate next step?

A 55-year-old male presents to his GP with bilateral breast tenderness and swelling over six months. He denies nipple discharge or other systemic symptoms. Past medical history is unremarkable, and he takes no regular medications. Physical examination reveals the findings shown in the image. Vital signs are normal. Initial investigations including liver function tests, renal function tests, thyroid function tests, LH, FSH, prolactin, and testosterone are all within normal limits. Considering the clinical presentation, image findings, and normal initial investigations, which of the following is the most appropriate next step in the evaluation of this patient?

A 62-year-old woman presents for a routine follow-up appointment several years after undergoing a simple mastectomy for pT1N0M0 invasive ductal carcinoma of the left breast. She completed adjuvant endocrine therapy and has been well since. During the consultation, she mentions that she has noticed a persistent area of skin change on her left chest wall, near the mastectomy scar, over the past few months. She describes it as occasionally itchy and slightly raised, but denies pain, discharge, or systemic symptoms such as weight loss or fever. Her vital signs are stable, and physical examination reveals no palpable axillary or supraclavicular lymphadenopathy. The appearance of the affected area is shown in the image. Considering the patient's history and the clinical presentation, what is the most appropriate initial diagnostic step?

Mrs. Eleanor Vance, a 62-year-old retired teacher, presents for her routine biennial screening mammogram through the BreastScreen Australia program. She has no personal history of breast disease, and her family history is negative for breast or ovarian cancer in first-degree relatives. She is otherwise healthy, with a history of diet-controlled type 2 diabetes and osteoarthritis managed with paracetamol. She denies any breast pain, lumps, nipple discharge, or skin changes. Her last mammogram two years ago was reported as normal (BIRADS 1). Physical examination of both breasts and axillae is unremarkable. The current screening mammogram is performed. The image provided is a magnified view from the craniocaudal projection of the left breast, specifically highlighting an area that has been flagged for further assessment by the reporting radiologist due to a change from the previous study. Assuming that subsequent investigation of the area highlighted in the image confirms a diagnosis of ductal carcinoma in situ (DCIS) and the patient undergoes breast-conserving surgery, which of the following factors is most important in determining the need for adjuvant radiotherapy?