During initial evaluation of a palpable breast mass in a patient under 35 years old, which imaging modality should be used?

In the evaluation of a palpable breast mass in a patient under 35 years old, ultrasonography is the most appropriate first-line imaging modality. This is primarily due to the fact that younger women typically have denser breast tissue, which can make it difficult for mammograms to provide clear images. Ultrasonography, on the other hand, is not affected by breast density and can effectively evaluate the characteristics of the mass, distinguishing between solid and cystic lesions.

In addition to its effectiveness in providing clarity regarding the nature of breast masses in younger patients, ultrasound is also beneficial because it can be performed quickly and does not involve exposure to radiation, making it a safer option for this demographic. If further investigation is warranted based on the ultrasound findings, other modalities, like mammography or magnetic resonance imaging, may be considered, but they are not the first step in this age group.