Breast Masses in Biological Females

Palpable breast masses are common among biological females, including pregnant and lactating individuals. Although most palpable breast masses are benign, breast cancer is one of the most common cancers. In 2019, there were an estimated 3.7 million individuals living with female breast cancer in the United States. Therefore, it is important that clinicians have the knowledge to appropriately evaluate breast masses. Risk factors for female breast cancer include, but are not limited to, exposure to menopausal hormone therapy, personal or family history of breast cancer, gene variants, chest wall radiation, age of menarche younger than 12 years, obesity, and alcohol use. A systematic approach for breast mass evaluation can help clinicians identify clinical features that increase suspicion of malignancy. Physical examination, breast imaging, and tissue biopsy are key diagnostic tools. For individuals who are younger than 30 years, lactating, or pregnant, the initial evaluation includes ultrasound, whereas mammogram with ultrasound is recommended for individuals 30 years or older. Tissue biopsy is necessary to evaluate a clinically suspicious mass.