US-guided core biopsy is also usually more easily tolerated because of a lack of breast compression and may allow biopsy of lesions difficult to access stereotactically (eg, far posterior lesions or axillary lesions) [30]. Image-Guided Fine Needle Aspiration Breast It is preferable for imaging to occur before biopsy because changes related to the biopsy may confuse, alter, obscure, and/or limit image interpretation. If a mammographically suspicious lesion is identified that correlates with the palpable mass, US is recommended as the next step in evaluation before image-guided FNA is pursued. However, the lack of sonographic correlate should not deter biopsy of a suspicious mammographic or DBT abnormality in this setting. 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. An additional consideration of FNAB over a core biopsy may be the faster turnover time for a pathology diagnosis without a difference in time to treatment [31]. At US-guided FNA, a marker clip is placed and a postprocedure mammogram confirms that the US and mammographic findings correlate. Similarly, a postprocedure DBT confirms that the US and DBT findings correlate. Palpable Breast Masses MRI Breast There is no relevant literature to support the use of MRI of the breast with or without IV contrast as the next step in evaluating a palpable mass in the context of a suspicious mammographic finding [2,23-25]. If malignancy is subsequently established by biopsy, MRI may be useful in delineating extent of disease in certain circumstances [32]. Sestamibi MBI There is no relevant literature to support the use of the use of Tc-99m sestamibi MBI as the next step in evaluating a palpable mass in the context of a suspicious mammographic finding. US Breast US may be helpful in characterizing a suspicious mammographic finding [33].
Palpable Breast Masses. US-guided core biopsy is also usually more easily tolerated because of a lack of breast compression and may allow biopsy of lesions difficult to access stereotactically (eg, far posterior lesions or axillary lesions) [30]. Image-Guided Fine Needle Aspiration Breast It is preferable for imaging to occur before biopsy because changes related to the biopsy may confuse, alter, obscure, and/or limit image interpretation. If a mammographically suspicious lesion is identified that correlates with the palpable mass, US is recommended as the next step in evaluation before image-guided FNA is pursued. However, the lack of sonographic correlate should not deter biopsy of a suspicious mammographic or DBT abnormality in this setting. 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. An additional consideration of FNAB over a core biopsy may be the faster turnover time for a pathology diagnosis without a difference in time to treatment [31]. At US-guided FNA, a marker clip is placed and a postprocedure mammogram confirms that the US and mammographic findings correlate. Similarly, a postprocedure DBT confirms that the US and DBT findings correlate. Palpable Breast Masses MRI Breast There is no relevant literature to support the use of MRI of the breast with or without IV contrast as the next step in evaluating a palpable mass in the context of a suspicious mammographic finding [2,23-25]. If malignancy is subsequently established by biopsy, MRI may be useful in delineating extent of disease in certain circumstances [32]. Sestamibi MBI There is no relevant literature to support the use of the use of Tc-99m sestamibi MBI as the next step in evaluating a palpable mass in the context of a suspicious mammographic finding. US Breast US may be helpful in characterizing a suspicious mammographic finding [33].