A 60-year-old woman comes to the office due to new-onset pelvic pressure. The patient reports increasing pelvic pressure over the last 3 months, now with associated urinary frequency. She has no abdominal pain, dysuria, or hematuria. The patient reports some dyspnea on exertion; review of systems is otherwise negative. The patient has a history of breast cancer at age 45; it was treated with radical mastectomy, chemotherapy, and adjuvant tamoxifen therapy. The cancer has since been in remission and she had a normal mammogram last year. The patient has no other chronic medical conditions. She underwent menopause 8 years ago and has had no episodes of postmenopausal vaginal bleeding. The patient has had no abnormal Pap tests, the last of which was 3 years ago. She does not use tobacco, alcohol, or illicit drugs. Blood pressure is 130/80 mm Hg, pulse is 80/min, and respirations are 18/min. BMI is 26 kg/m2. Decreased breath sounds are noted over the lower base of the right lung. Abdominal examination reveals normoactive bowel sounds and mild distension but no tenderness. On bimanual examination, a 12-week-sized, irregularly shaped uterus is noted, but there are no adnexal masses. Urinalysis is within normal limits. Pelvic ultrasound shows a dense focal mass measuring 9 cm in the anterior fundus of the uterus, normal ovaries bilaterally, and a moderate amount of free fluid in the posterior cul-de-sac. Which of the following is the best next step in management of this patient?
A)Administer gonadotropic-releasing hormone agonist
B)Observe and perform repeat ultrasound in 3 months
E)Perform uterine artery embolization