A 58-year-old woman presents with a 1-month history of burning, itching, and scaling skin around her right areola. This presentation appears similar to contact dermatitis or eczema, and you prescribe a trial of 1% hydrocortisone ointment and recommend that she follow-up with you in 2 weeks.
On her return visit, there has been no significant improvement. In addition to mammography, the next diagnostic step would include which of the following?
- referral to a breast surgeon for possible small excisional biopsy of areolar tissue to rule out lobular carcinoma in situ
- course of empiric antibiotics to treat a superimposed infectious component
- referral to a breast surgeon for possible small excisional biopsy of areolar tissue to rule out Paget disease and associated ductal carcinoma in situ
- referral to a breast surgeon for possible small excision of the involved duct to rule out duct ectasia
This question appears in Med-Challenger Internal Medicine Exam Review with CME
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