Approach to breast pain (mastalgia) Quiz: Ace Your Exams

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A 32-year-old woman presents to the OB/GYN clinic reporting diffuse, bilateral breast pain that consistently occurs in the week leading up to her menstrual period. The pain, described as dull and aching, has been ongoing for several months and worsens during the luteal phase of the menstrual cycle, improving after menstruation begins. The patient reports no palpable lumps, nipple changes, or skin abnormalities. The medical history is unremarkable, and no medications are taken. Temperature is 37°C (98.6°F), pulse is 72/min, respirations are 14/min, and blood pressure is 110/66 mmHg. Physical examination reveals no masses, skin changes, or nipple abnormalities. The pelvic exam is normal. No imaging or laboratory tests have been performed yet. Which of the following is indicated?

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Core needle biopsy

Ultrasound

Mammogram

No additional testing is required.

Ultrasound and mammogram