Evaluation of a Breast Mass

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Abstract
The Current Concepts article by Donegan (Sept. 24 issue)1 on the management of palpable breast masses raises several important issues that should be clarified. Although the term “diagnostic mammography” is commonly used, mammography is rarely diagnostic in the sense of “distinguishing one disease from another”2. Mammography is almost exclusively a screening technique. It is rare that the mammogram can characterize a palpable lesion sufficiently that no further evaluation is needed. Even specially targeted mammographic views may fail to image the palpable abnormality. Mammography should be used in a woman who has a mass, but it should be used primarily to screen the clinically normal, ipsilateral breast tissue and the contralateral breast in order to detect occult cancer3.