The diagnostic evaluation

Breast symptoms are appropriately evaluated by a breast-oriented history and by the diagnostic triad of clinical breast examination, FNA, and mammography. In the case of a palpable dominant mass, concordance of the diagnostic triad yields a reliable clinical diagnosis. If there is not concordance, or if there is any doubt about the diagnosis either on the part of the physician or the patient, open surgical biopsy provides the definitive histologic diagnosis. The goal in clinical practice is to detect nonpalpable cancers by ordering screening mammography for all patients eligible by age, history, or both. The long-term cancer-free survival of women treated for nonpalpable breast cancer is excellent.