From the Guidelines
For a breast lump in a 31-year-old, a mammogram is not the first recommended imaging test, and instead, an ultrasound is usually the preferred initial imaging approach. This recommendation is based on the understanding that breast cancer is less common in younger women, and that dense breast tissue in younger women reduces the sensitivity of mammography 1. The evaluation process should begin with a clinical breast examination by a healthcare provider, followed by ultrasound imaging.
Key Points to Consider
- Ultrasound is more effective at evaluating breast tissue in younger women, who tend to have denser breast tissue that can make mammogram interpretation challenging 1.
- For women aged 30 to 39 years, either US or diagnostic mammography or DBT can be used for initial evaluation, but ultrasound is generally preferred due to its higher sensitivity in this age group 1.
- If the ultrasound findings are concerning or inconclusive, additional imaging such as a mammogram or MRI might then be recommended 1.
- In some cases, a biopsy may be necessary to determine if the lump is benign or malignant.
- Any persistent or concerning breast lump should always be evaluated promptly by a healthcare provider, regardless of age.
Imaging Recommendations
- Breast US is the initial imaging modality of choice for evaluating a clinically detected palpable breast mass in a woman younger than age 30 years 1.
- For women aged 30 to 39 years, either US or diagnostic mammography or DBT can be used for initial evaluation 1.
- Correlation between imaging and the palpable area of concern is essential 1.