American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the diagnostic test of choice for most solid breast lesions?

1. Ultrasound

2. Mammogram

3. Core needle biopsy

4. Fine needle aspiration

The correct answer is: Core needle biopsy

The diagnostic test of choice for most solid breast lesions is largely recognized as the core needle biopsy. This procedure involves using a hollow needle to obtain a sample of tissue from the breast lesion for examination. Core needle biopsy is preferred because it allows for the retrieval of a larger tissue sample compared to fine needle aspiration, which generally provides only a small amount of cells without the surrounding architecture necessary for accurate diagnosis. Additionally, core needle biopsy is more specific and can provide information about the presence of invasive cancer, distinguishing between benign and malignant lesions effectively. The pathology results from this biopsy can guide clinical decision-making regarding further management or treatment of the lesion. While mammograms and ultrasounds are essential tools in breast imaging and can help in the initial evaluation of breast abnormalities, they are generally not definitive for diagnosis. Instead, they serve as preliminary tests that help in identifying lesions that might require further diagnostic evaluation, such as a core needle biopsy.