If a palpable breast mass is not visible on initial imaging, what should be done next?

In the scenario where a palpable breast mass is not visible on initial imaging, the appropriate next step is to use a different imaging modality. This approach is based on the principle that different imaging techniques can provide varying levels of detail and visualization depending on the characteristics of the mass and the tissue surrounding it.

For example, if mammography does not show a palpable mass, an ultrasound may be more effective in evaluating the tissue in that area, particularly when it comes to differentiating a solid mass from a cystic one. Conversely, if the ultrasound was done first and did not reveal the mass, an MRI may be employed to provide a more comprehensive view. Different modalities can enhance the likelihood of identifying the mass and providing further information about its characteristics.

Utilizing multiple imaging techniques helps healthcare providers make informed decisions regarding further evaluation or intervention, leading to a clearer diagnosis. In contrast, merely repeating the same imaging modality may not yield new information if the initial study was inconclusive. Similarly, performing a biopsy without additional imaging can potentially miss characterizing the mass accurately, while referral to oncology may be considered later, depending on the findings from the next imaging study.