Image-Guided Core Biopsy Breast There is no relevant literature to support the use of image-guided core biopsy as the next step in the evaluation of a woman presenting with a negative mammogram and a palpable mass. US should be performed, and if a suspicious correlate is identified, then US-guided core biopsy is recommended. However, a suspicious physical examination should prompt biopsy guided by palpation, regardless of negative imaging findings [38]. Image-Guided Fine Needle Aspiration Breast There is no relevant literature to support the use of image-guided FNAB as the next step in the evaluation of a woman presenting with a negative mammogram and a palpable mass. US should be performed, and if a suspicious correlate is identified, then US-guided core biopsy is recommended. However, a suspicious physical examination should prompt biopsy guided by palpation, regardless of negative imaging findings [38]. MRI Breast MRI of the breast with or without IV contrast for women with a palpable mass and negative mammography is not recommended as the next imaging study [2,23-25]. US should be performed next [8,9,19]. Palpable Breast Masses Sestamibi MBI There is no relevant literature to support the use of the use of Tc-99m sestamibi MBI as the next step in the evaluation of a woman presenting with a negative mammogram and a palpable mass. US Breast A major advantage of US is the ability to directly correlate the clinical and imaging findings. The use of multiple modalities in diagnosing palpable masses has been advocated as a measure to increase the true-positive rate. In 3 series evaluating palpable breast abnormalities [18-20], the sensitivity of mammography was 86% to 91%. The addition of US detects 93% to 100% of cancers [8,9,19]. The addition of US to mammography may also improve detection of a benign etiology for a palpable finding and may also identify lesions that are mammographically occult [26]. In a series, 40% of benign palpable masses were identified only on US [20].
Palpable Breast Masses. Image-Guided Core Biopsy Breast There is no relevant literature to support the use of image-guided core biopsy as the next step in the evaluation of a woman presenting with a negative mammogram and a palpable mass. US should be performed, and if a suspicious correlate is identified, then US-guided core biopsy is recommended. However, a suspicious physical examination should prompt biopsy guided by palpation, regardless of negative imaging findings [38]. Image-Guided Fine Needle Aspiration Breast There is no relevant literature to support the use of image-guided FNAB as the next step in the evaluation of a woman presenting with a negative mammogram and a palpable mass. US should be performed, and if a suspicious correlate is identified, then US-guided core biopsy is recommended. However, a suspicious physical examination should prompt biopsy guided by palpation, regardless of negative imaging findings [38]. MRI Breast MRI of the breast with or without IV contrast for women with a palpable mass and negative mammography is not recommended as the next imaging study [2,23-25]. US should be performed next [8,9,19]. Palpable Breast Masses Sestamibi MBI There is no relevant literature to support the use of the use of Tc-99m sestamibi MBI as the next step in the evaluation of a woman presenting with a negative mammogram and a palpable mass. US Breast A major advantage of US is the ability to directly correlate the clinical and imaging findings. The use of multiple modalities in diagnosing palpable masses has been advocated as a measure to increase the true-positive rate. In 3 series evaluating palpable breast abnormalities [18-20], the sensitivity of mammography was 86% to 91%. The addition of US detects 93% to 100% of cancers [8,9,19]. The addition of US to mammography may also improve detection of a benign etiology for a palpable finding and may also identify lesions that are mammographically occult [26]. In a series, 40% of benign palpable masses were identified only on US [20].