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MMLU / A 46-year-old woman, gravida 1, para 1, comes to the office because of a 2-week…

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question

A 46-year-old woman, gravida 1, para 1, comes to the office because of a 2-week history of black discharge from her right nipple. The patient had mammography and ultrasonography of the breasts 2 months ago for evaluation of increased glandularity, palpated in the upper outer quadrant of the right breast, noted at her most recent annual examination. The studies showed likely benign findings with recommended follow-up in 6 months. Medical history is otherwise unremarkable and she takes no medications. BMI is 30 kg/m2 . Vital signs are normal. Palpation of the right breast discloses glandularity in the upper outer quadrant but no other masses. There is scant, black discharge from the right nipple. Which of the following is the most appropriate next step in diagnosis?

choices

  1. Ductography
  2. Excisional biopsy of glandular tissue
  3. Repeat mammography
  4. Repeat ultrasonography of the right breast

subject

professional_medicine

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