Case 23 continued

A large dominant mass is present in the left subareolar area. Multiple smaller benign-appearing masses are present bilaterally. Recommend ultrasound to evaluate cyst from solid mass. If a cyst is found, the work-up is complete. If the mass is solid, then spot compression magnification mammography would be indicated.

Multiple bilateral benign-appearing masses are considered benign and an ultrasound is not necessary [Leung and Sickles, AJR 2000 Jul;175(1):23-9] (unless, as in this case, there is a dominant mass). Whenever multiple masses are seen at screening mammography, one should include a recommendation for work-up of any palpable lump with either aspiration or ultrasound.

Ultrasound was performed:

When is aspiration necessary?