Image-Guided Fine Needle Aspiration Breast There is no relevant literature to support the use of image-guided FNAB as the next step in evaluating a palpable mass in the context of a benign mammographic finding. However, image-guided aspiration can be considered for symptomatic relief of a palpable simple cyst. MRI Breast There is no relevant literature to support the use of MRI of the breast with or without IV contrast of the breast as the next step in evaluating a palpable mass in the context of a benign mammographic finding. Sestamibi MBI There is no relevant literature to support the use of Tc-99m sestamibi MBI as the next step in evaluating a palpable mass in the context of a benign mammographic finding. US Breast When the mammogram shows a definite benign mass (eg, lymph node, hamartoma, lipoma, calcified fibroadenoma, or oil cyst), US is not necessary as long as the benign mass identified on mammography is a definitive correlate of the clinical finding. If correlation between the mammographic finding and the palpable lesion is uncertain, US is useful. US is preferably targeted specifically to the palpable finding [33]. When both mammography and US are negative or benign in the evaluation of a palpable breast mass, the negative predictive value exceeds 97% [8,9,38]. Together, these imaging modalities can be reassuring when the physical examination is not highly suspicious and clinical follow-up is planned. However, a suspicious physical examination should prompt biopsy regardless of benign imaging findings [38]. Variant 5: Adult female, 40 years of age or older. Palpable breast mass. Mammography findings are negative (BI-RADS 1). Next imaging study. FDG-PET Breast Dedicated There is no relevant literature to support the use of FDG-PET breast dedicated as the next step in the evaluation of a woman presenting with a negative mammogram and a palpable mass [2].
Palpable Breast Masses. Image-Guided Fine Needle Aspiration Breast There is no relevant literature to support the use of image-guided FNAB as the next step in evaluating a palpable mass in the context of a benign mammographic finding. However, image-guided aspiration can be considered for symptomatic relief of a palpable simple cyst. MRI Breast There is no relevant literature to support the use of MRI of the breast with or without IV contrast of the breast as the next step in evaluating a palpable mass in the context of a benign mammographic finding. Sestamibi MBI There is no relevant literature to support the use of Tc-99m sestamibi MBI as the next step in evaluating a palpable mass in the context of a benign mammographic finding. US Breast When the mammogram shows a definite benign mass (eg, lymph node, hamartoma, lipoma, calcified fibroadenoma, or oil cyst), US is not necessary as long as the benign mass identified on mammography is a definitive correlate of the clinical finding. If correlation between the mammographic finding and the palpable lesion is uncertain, US is useful. US is preferably targeted specifically to the palpable finding [33]. When both mammography and US are negative or benign in the evaluation of a palpable breast mass, the negative predictive value exceeds 97% [8,9,38]. Together, these imaging modalities can be reassuring when the physical examination is not highly suspicious and clinical follow-up is planned. However, a suspicious physical examination should prompt biopsy regardless of benign imaging findings [38]. Variant 5: Adult female, 40 years of age or older. Palpable breast mass. Mammography findings are negative (BI-RADS 1). Next imaging study. FDG-PET Breast Dedicated There is no relevant literature to support the use of FDG-PET breast dedicated as the next step in the evaluation of a woman presenting with a negative mammogram and a palpable mass [2].