Marley Lawson was fouled on a successful two-pointer — her first basket of the game after four misses — and made her only free-throw attempt to nudge Madison Southern past Berea into the 44th District finals, 50-49.
Victoria Sexton missed a three-point try at the buzzer for the Lady Pirates (11-16).
Briana Lanham went 8-for-16 on her way to 26 points and brought down 21 rebounds for Madison Southern (20-6), which has won eight of its last nine games.
Berea led by seven points with 6:44 left to play, but Lanham went on a personal 8-0 run over a 79-second span to give the Eagles a lead with 5:25 to go.
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The Pirates quickly went back up after Jordan Sandefur connected on two free throws, but Lanham hit her only three-pointer of the game to put the Eagles back in front.
Sandefur tied the game on a three-pointer with 1:07 left, and the Pirates took their final lead on a layup by Chase Fain with 39 seconds left.
Madison Southern will meet Madison Central, 66-35 winners over Model on Tuesday, for a shot at the district title.
Male 55, Assumption 32 (26th): Illyah Green had 12 points for the Bulldogs (20-9), leading nine Male players who scored versus the Rockets (7-18).
Woodford Co. 66, Frankfort 57 (41st): Eli Boggess scored 26 points and had seven rebounds as the Yellowjackets surged for 28 points in the fourth quarter.
Grayson Graf added 20 points and five rebounds for Woodford (15-14), which went 7-for-17 from behind the arc.
The Yellowjackets went 27-for-34 at the foul line, with Boggess (11-for-13) and Graf (10-for-12) leading the way.
Jalen Washington had 32 points for the Panthers (5-24) to lead all scorers.
Madison Southern 87, Berea 59 (44th): Michael Jefferson and Brandon Sargent each scored 13 points to pace the Eagles (13-15) in their third straight win.
Dustin Kates and Jarrel Tevis led the Pirates (6-20) with 11 points apiece.
No. 19 Perry Co. Central 69, Buckhorn 56 (54th): Justin Johnson had 22 points and 20 rebounds in the win for the Commodores (21-7).