American Board of Internal Medicine (ABIM) Certification Practice Exam

When is an excisional biopsy of a breast mass indicated?

1. When patient requests it

2. When core needle biopsy findings are nondiagnostic

3. When imaging studies are inconclusive

4. When a family history of cancer exists

The correct answer is: When core needle biopsy findings are nondiagnostic

An excisional biopsy of a breast mass is indicated when core needle biopsy findings are nondiagnostic. This is because a core needle biopsy, which involves taking a small sample of the breast tissue, may not provide enough information to make a definitive diagnosis. In cases where the results are inconclusive or ambiguous, an excisional biopsy, which removes the entire mass or area of concern, allows for a thorough histopathological evaluation. This can ensure accurate diagnosis and appropriate management of potential breast cancer. While the other situations involving patient requests, inconclusive imaging studies, or family history of cancer could lead to further evaluation or interventions, the need for excisional biopsy is most directly related to the inadequacy of previous biopsy results. In cases where the core needle biopsy has not provided a definitive diagnosis, moving forward with an excisional biopsy becomes crucial to clarify the pathology of the mass.