American Board of Internal Medicine (ABIM) Certification Practice Exam

For individuals aged 30 and above presenting with a breast lump, what imaging technique is recommended?

1. Ultrasound

2. Mammography

3. X-ray

4. Core biopsy

The correct answer is: Mammography

For individuals aged 30 and above who present with a breast lump, mammography is the recommended imaging technique. This is primarily due to the higher likelihood of finding breast cancer in this demographic, and mammography is particularly effective in detecting masses and calcifications that may indicate malignancy. Mammography utilizes low-dose X-rays specifically designed to examine breast tissue and can identify abnormalities that may not be palpable during a physical exam. It is most beneficial as a screening tool and is also used for diagnostic purposes if a lump has been identified. The guideline emphasizes that women over 30 should ideally undergo a mammogram when presenting with breast symptoms, especially if there are risk factors for breast cancer or if the lump has persistent features that warrant further investigation. While ultrasound can be helpful in characterizing a lump—distinguishing between solid and cystic masses—it is typically used as an adjunct to mammography rather than the primary initial imaging for those over 30 with a breast lump. Core biopsy is a procedure utilized to obtain tissue samples for further evaluation but does not serve as an imaging technique. X-rays, while useful in many medical settings, are not indicated for breast evaluation. Overall, mammography remains the standard initial assessment tool for those aged 30 and older presenting