CMS OBS/GYN form 1. Breast mass - antonse

[ArchivalUser]

A 47-year-old woman comes to the physician 2 weeks after she found a lump in her left breast during self-examination. She started estrogen replacement therapy 3 months ago and has had breast engorgement since that time. Examination of the left breast shows a 2-cm, tense, mobile, cyst-like structure at the 11-o'clock position. There is no breast discharge or palpable axillary nodes. The right breast is normal. Mammography 3 months ago showed normal findings. Which of the following is the most appropriate next step in management?
A) Repeat mammography
B) Decrease the dose of estrogen
C) Discontinue estrogen replacement therapy
D) Fine-needle aspiration biopsy of the cyst
E) Excisional biopsy
Choosing between A and D. I think mammography should always be the firs step in evaluating breast mass in women after 35. But according to the answers the correct is D. What do you think?

[ArchivalUser]

there is a similar question in uworld question id no: 11970, diff is that she is young and has recently withdrawn OCps. fibrocystc disease is result of fluctuations in estrogen and progesterone. this patient is having this cystic change after hormone replacement 3 months ago. to think cheap ya I would go with B)..