Breast lumps other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]


The only certain method to approve the presence of breast malignancy is breast lump biopsy.The three types of biopsies are core-needle biopsy, open surgical biopsy, and fine needle biopsy. Core-needle biopsy has different types such as ultrasound guided-core needle biopsy, stereotactic-guided core-needle biopsy, MRI-guided core-needle biopsy, and freehand core-needle biopsy. Core-needle biopsy has high sensitivity and specificity. Triple test score is used by surgeons for assessment of palpable breast lumps. Classic type of triple test includes clinical breast examination, FNA, and mammography and modified version includes clinical breast examination, core-needle biopsy and ultrasound.

Other Diagnostic Studies


The only certain method to approve the presence of breast malignancy is breast lump biopsy.[1]

There are three types of biopsy:

  • Core-needle biopsy
  • Open surgical biopsy
  • Fine needle biopsy[2]

Core-needle biopsy:[1]

Core-needle biopsy has lower risk of complications such as bleeding, bruising and infection

Open surgical biopsy:[1]

Fine needle biopsy (FNA):[2]

  • Performed by small needle (21-25 gauge)
  • Regarding to small amount of breast tissue, FNA is considered as controversial method for breast lump diagnosis
  • Performed for large and symptomatic breast cysts or imaginary abnormalities
  • Complications of FNA include bruising, bleeding, pain, infection and pneumothorax; if needle goes deep inside the chest)
  • Due to inadequate tissue or nondiagnostic results, FNA has lower rate of diagnosis rather than core-needle biopsy
  • FNA advantages:
  • FNA follow-up:
    • Non-bloody fluid/resolved cyst
      • Ultrasound follow-up to reassure the cyst has been resolved
      • No more follow-up
    • Bloody fluid/ persistent cyst
      • Refer to a surgeon for open surgical biopsy

Triple test score is used by surgeons for assessment of palpable breast lumps:[5][6]


  1. 1.0 1.1 1.2 John M. Eisenberg Center for Clinical Decisions and Communications Science. Having a Breast Biopsy: A Review of the Research for Women and Their Families. 2016 May 26. In: Comparative Effectiveness Review Summary Guides for Consumers [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2005-. Available from:
  2. 2.0 2.1 Casaubon JT, Regan JP. Breast Masses, Fine Needle Aspiration. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from:
  3. Yeow KM, Lo YF, Wang CS, Chang HK, Tsai CS, Hsueh C (2001). "Ultrasound-guided core needle biopsy as an initial diagnostic test for palpable breast masses". J Vasc Interv Radiol. 12 (11): 1313–7. PMID 11698631.
  4. Ward ST, Shepherd JA, Khalil H (2010). [htps:// "Freehand versus ultrasound-guided core biopsies of the breast: reducing the burden of repeat biopsies in patients presenting to the breast clinic"]. Breast. 19 (2): 105–8. doi:10.1016/j.breast.2009.12.003. PMID 20074953.
  5. Morris KT, Pommier RF, Morris A, et al. Usefulness of the Triple Test Score for Palpable Breast Masses. Arch Surg. 2001;136(9):1008–1013. doi:10.1001/archsurg.136.9.1008
  6. Wai CJ, Al-Mubarak G, Homer MJ, Goldkamp A, Samenfeld-Specht M, Lee Y; et al. (2013). "A modified triple test for palpable breast masses: the value of ultrasound and core needle biopsy". Ann Surg Oncol. 20 (3): 850–5. doi:10.1245/s10434-012-2710-y. PMID 23104707.
  7. Santen RJ. Benign Breast Disease in Women. [Updated 2018 May 25]. In: De Groot LJ, Chrousos G, Dungan K, et al., editors. Endotext [Internet]. South Dartmouth (MA):, Inc.; 2000-. Available from:

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