American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended action for a palpable breast mass even when mammogram results are negative?

1. Perform a follow-up mammogram

2. Refer to a specialist without further testing

3. Conduct a biopsy

4. Monitor the mass for changes

The correct answer is: Conduct a biopsy

The recommended action for a palpable breast mass, even when mammogram results are negative, is to conduct a biopsy. This is because a negative mammogram does not entirely rule out the possibility of breast cancer or other significant conditions. In cases where a mass can be felt but is not detected on imaging, a biopsy becomes crucial to obtain tissue samples for pathological examination. This helps establish a definitive diagnosis, particularly if there are concerning characteristics associated with the mass. Breast tissue can sometimes present abnormalities that mammography might miss, especially in women with dense breast tissue. Therefore, performing a biopsy ensures that any potential malignancy is identified and managed appropriately, rather than relying solely on imaging studies. Monitoring the mass or referring to a specialist without further testing does not address the immediate need for a clear diagnosis, while a follow-up mammogram would not provide any additional information regarding the nature of the mass.