Image-Guided Fine Needle Aspiration Breast If a palpable mass has probably benign features as identified on mammogram and/or US, imaging follow-up may be appropriate. However, if a mass is new on imaging or increasing by >20% in volume or >20% in each diameter in a 6-month period, image-guided biopsy is recommended [36]. In addition, there are certain cases in which biopsy may be performed even on probably benign lesions. For example, BI-RADS 3 lesions in high-risk patients, patients awaiting organ transplant, patients with known synchronous cancers, or patients trying to get pregnant may be appropriate for tissue sampling. In addition, situations in which biopsy may alleviate extreme patient anxiety may prompt tissue sampling [30,37]. Large series have demonstrated core biopsy is superior to FNAB in terms of sensitivity, specificity, and correct histological grading of palpable masses [27]. In addition, core biopsy allows for ready evaluation of tumor receptor status. FNAB; however, may allow a faster turnover time as compared with core biopsy for a pathology diagnosis without a difference in time to treatment [31]. At image-guided FNA, a marker clip is placed and a postprocedure mammogram/DBT confirms that the marker clip and mammographic/DBT findings correlate. Palpable Breast Masses Variant 4: Adult female, 40 years of age or older. Palpable breast mass. Mammography findings are benign (BI-RADS 2) at the site of palpable mass. 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 evaluating a palpable mass in the context of a benign mammographic finding [2]. Image-Guided Core Biopsy Breast There is no relevant literature to support the use of image-guided core biopsy breast as the next step in evaluating a palpable mass in the context of a benign mammographic finding.
Palpable Breast Masses. Image-Guided Fine Needle Aspiration Breast If a palpable mass has probably benign features as identified on mammogram and/or US, imaging follow-up may be appropriate. However, if a mass is new on imaging or increasing by >20% in volume or >20% in each diameter in a 6-month period, image-guided biopsy is recommended [36]. In addition, there are certain cases in which biopsy may be performed even on probably benign lesions. For example, BI-RADS 3 lesions in high-risk patients, patients awaiting organ transplant, patients with known synchronous cancers, or patients trying to get pregnant may be appropriate for tissue sampling. In addition, situations in which biopsy may alleviate extreme patient anxiety may prompt tissue sampling [30,37]. Large series have demonstrated core biopsy is superior to FNAB in terms of sensitivity, specificity, and correct histological grading of palpable masses [27]. In addition, core biopsy allows for ready evaluation of tumor receptor status. FNAB; however, may allow a faster turnover time as compared with core biopsy for a pathology diagnosis without a difference in time to treatment [31]. At image-guided FNA, a marker clip is placed and a postprocedure mammogram/DBT confirms that the marker clip and mammographic/DBT findings correlate. Palpable Breast Masses Variant 4: Adult female, 40 years of age or older. Palpable breast mass. Mammography findings are benign (BI-RADS 2) at the site of palpable mass. 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 evaluating a palpable mass in the context of a benign mammographic finding [2]. Image-Guided Core Biopsy Breast There is no relevant literature to support the use of image-guided core biopsy breast as the next step in evaluating a palpable mass in the context of a benign mammographic finding.