Diagnostic algorithm for palpable breast abnormalities in patients aged 40 years and over

BI-RADS: Breast Imaging-Reporting and Data System; US: ultrasound; CNB: core needle biopsy.
* BI-RADS 4C and 5 lesions require surgical evaluation prior to percutaneous biopsy. The presence and size of a mass may influence the choice of biopsy method.
¶ Not all high-risk benign lesions require surgical excision; practices also vary between excision and observation for lesions with atypia. Refer to UpToDate topic on atypia and lobular carcinoma in situ for details.