Review Question - QID 210598

Patient 1 – A 26-year-old woman presents to her primary care physician for an annual exam. She currently does not have any acute concerns and says her health has been generally well. Medical history is significant for asthma, which is managed with an albuterol inhaler. Her last pap smear was unremarkable. She is currently sexually active with one male and consistently uses condoms. She occasionally smokes marijuana and drinks wine once per week. Her mother recently passed away from advanced ovarian cancer. Her sister is 37-years-old and was recently diagnosed with breast cancer and ovarian cancer. Her temperature is 98.7°F (37°C), blood pressure is 107/68 mmHg, pulse is 58/min, respirations are 12/min, and oxygen saturation is 99% on room air. Physical examination is remarkable for a mildly anxious woman.

Patient 2 – A 27-year-old woman presents to her primary care physician for an annual exam. She says that she would like to be screened for breast cancer since two of her close friends were recently diagnosed. She noticed she has a small and mobile mass on her left breast, which increases in size and becomes tender around her time of menses. Family history is remarkable for hypertension in the father. Her temperature is 98.7°F (37°C), blood pressure is 117/69 mmHg, pulse is 62/min, respirations are 13/min, and oxygen saturation is 99% on room air. The physical exam is significant for a small, well-defined, and mobile mass on her left breast that is not tender to palpation.

Which of the following is the most appropriate next step in management for patients 1 and 2?