The radiologic workup of a palpable breast mass

  title={The radiologic workup of a palpable breast mass},
  author={Lauren Jordan Alexander Stein and Melanie Chellman-Jeffers},
  journal={Cleveland Clinic Journal of Medicine},
  pages={175 - 180}
The finding of a palpable breast mass on physical examination often warrants a radiologic workup including directed ultrasonography, diagnostic mammography, and, at times, biopsy with ultrasonographic guidance. The choice of initial imaging study is most often guided by the patient’s age at presentation. Communicating the clinical findings to both the patient and the radiologist helps ensure the selection of the most appropriate imaging studies and helps in the interpretation of those studies… 

Is there a role for magnetic resonance imaging in diagnosing palpable breast masses when mammogram and ultrasound are negative?

When used for evaluation of a palpable breast mass with negative traditional imaging, breast MRI likely offers low yield of cancer diagnosis and low specificity, and may cause a low compliance rate for recommended follow-up.

Evaluation of breast lesions with Ultrasonography and Mammography in Correlation with FNAC/HPE

Higher combined specificity of ultrasonography and mammography for detecting breast masses including malignancies is found, however it is better advised to undergo both the modalities for diagnostic accuracy.

Do Primary Care Physician Perform Clinical Breast Exams Prior to Ordering a Mammogram?

Despite recommendations, approximately 1/3 of women report not having CBE prior to mammogram, with possibly increased cost and delay in diagnosis, and the chances of having a CBE varied significantly by PCP specialty.

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The results of this study indicate that the diagnosis of breast cancer in young women is late, in the stage with palpable breast tumor and lymph node metastases, and the implementation of algorithms for breast cancer detection and diagnosis in youngWomen helps in earlier detection of breastcancer and consequently improves outcomes.

Benign Breast Conditions



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Ultrasound use should be considered in most instances of a palpable breast finding, particularly in young women, and a suspicious dominant palpable finding should be further evaluated even if imaging is negative, which may reassure women with low-suspicion palpable findings.

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A succinct overview of normal breast anatomy is provided and common causes of breast masses are reviewed and an algorithm is provided for optimal utilization of available tools in the diagnostic evaluation of a breast mass.

Evaluation of palpable breast masses.

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After the clinical breast examination is performed, the evaluation depends largely on the patient's age and examination characteristics, and the physician's experience in performing fine-needle aspiration.

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Who should have breast magnetic resonance imaging evaluation?

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Technical requirements for optimal breast imaging including the requirement for a breast MRI biopsy system are now being defined as part of a voluntary American College of Radiology breast MRI accreditation program.

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Data from prospective databases that are currently recruiting will provide further important information concerning the management of this condition, and in particular the long-term sequelae for mother and fetus.

Management of the pregnant patient with carcinoma of the breast.

Fears of fetal exposure to radiation should not deter a physician from ordering appropriate preoperative diagnostic tests to stage the patients and the involvement of multiple subspecialties in the management of these patients is highly recommended.

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