Palpable breast mass: age <30 y → observe for resolution over 1–2 menstrual cycles; age <30 y, unchanging mass → U/S → aspiration if mass not simple cyst;
age >30 y or solid mass on U/S or bloody aspirate or recurrence after aspiration → mammo (detect other lesions) and either fine-needle asp. or core-needle bx
clearly cancerous on exam or indeterminate read or atypia on bx → excisional bx
Suspicious mammogram with normal exam: stereotactically guided bx
MRI: detects contralateral cancer in 3% of Pts w/ recently dx breast cancer & contra-lateral mammo (but PPV only 21%) (NEJM 2007;356:1295); utility remains unclear