Evaluation of breast mass

Breast masses are a common clinical finding. The majority of palpable breast masses are benign, but 10% of women who present with this finding will have a diagnosis of cancer.[1]Barton MB, Elmore JG, Fletcher SW. Breast symptoms among women enrolled in a health maintenance organization: frequency, evaluation, and outcome. Ann Intern Med. 1999 Apr 20;130(8):651-7. http://www.ncbi.nlm.nih.gov/pubmed/10215561?tool=bestpractice.com Approximately 4% of breast cancers will present with a palpable mass and no mammographic or ultrasonographic evidence of disease.[2]Beyer T, Moonka R. Normal mammography and ultrasonography in the setting of palpable breast cancer. Am J Surg. 2003 May;185(5):416-9. http://www.ncbi.nlm.nih.gov/pubmed/12727559?tool=bestpractice.com

A delayed or missed breast cancer diagnosis can severely affect patient outcome.

Evaluation of a breast mass is guided by findings on history, physical exam, imaging, and biopsy.[3]Practice bulletin no. 164: diagnosis and management of benign breast disorders. Obstet Gynecol. 2016 Jun;127(6):e141-56. http://www.ncbi.nlm.nih.gov/pubmed/27214189?tool=bestpractice.com ​ A triple test of clinical breast exam, imaging (e.g., mammography and ultrasonography), and needle biopsy can lead to a definitive diagnosis in nearly all cases.[4]Vetto JT, Pommier RF, Schmidt WA, et al. Diagnosis of palpable breast lesions in younger women by the modified triple test is accurate and cost-effective. Arch Surg. 1996 Sep;131(9):967-72. http://www.ncbi.nlm.nih.gov/pubmed/8790167?tool=bestpractice.com [5]Vetto JT, Pommier RF, Schmidt WA, et al. Use of the "triple test" for palpable breast lesions yields high diagnostic accuracy and cost savings. Am J Surg. 1995 May;169(5):519-22. http://www.ncbi.nlm.nih.gov/pubmed/7747833?tool=bestpractice.com [6]Morris A, Pommier RF, Schmidt WA, et al. Accurate evaluation of palpable breast masses by the triple test score. Arch Surg. 1998 Sep;133(9):930-4. http://archsurg.jamanetwork.com/article.aspx?articleid=211721 http://www.ncbi.nlm.nih.gov/pubmed/9749842?tool=bestpractice.com