Repeated USMLE Questions Step 1 - 155

A 23-year-old woman presents to the clinic with a complaint of pain in her left breast since last night. She is breastfeeding her 1-week-old girl. On examination, her temperature is 99.8 F, her pulse is 88/min. and her blood pressure is 120/80. Local examination of the left breast reveals a localized soft tender 1-inch area. Her past medical, surgical and family histories are unremarkable. What is the most likely diagnosis?

A- A clogged milk duct

B- A breast abscess

C- Milk engorgement

D- Mastitis

E- Inflammatory carcinoma




Answer

This is a presentation of a clogged milk duct in which the mass is localized, tender, and not erythematous or firm. There is no fever or any signs of acute inflammation. There is also no signs or family history of cancer. Abscess occurs later if this mass is infected and no treatment applied. Milk engorgement results in generalized involvement of both breasts. A clogged milk duct is diagnosed mainly by exclusion.

The correct answer is A