Painful, Hot Fluctuant Lump on Chin of Breast Cancer Patient

Poll

A 31-year-old woman has undergone a lumpectomy for a small, estrogen receptor–positive breast tumor. She is receiving chemotherapy prior to local radiation. She acutely develops a painful, hot fluctuant lump on her chin. She is afebrile.

What would be the most appropriate thing to do first?

A. Tell the patient that her cancer has spread to the skin.
B. Incise and drain the lesion, and send some purulent material for bacterial and fungal culture with reflex sensitivity.
C. Hospitalize the patient for several days of broad-spectrum intravenous antibiotics before drainage is attempted.
D. Order an urgent PET scan.