Breast Cancer Screening and Diagnostic Workup

Key Points

• Screening and diagnostic planning are individualized by risk profile, age, and symptom status.
• BI-RADS standardized reporting supports next-step decision making after mammography or ultrasound.
• Prompt progression from abnormal screening to diagnostic imaging and biopsy reduces delayed diagnosis risk.

Equipment

• Mammography access (digital system preferred when available)
• Ultrasound and MRI scheduling pathways for adjunct imaging
• Biopsy preparation materials and specimen labeling workflow
• Patient education materials for test expectations and follow-up instructions

Procedure Steps

1. Perform baseline risk assessment, including age, personal and family history, and modifiable/nonmodifiable risk factors.
2. Confirm whether the patient is asymptomatic screening or symptomatic diagnostic evaluation.
3. Arrange mammography according to risk-informed plan and local guideline set.
4. Review BI-RADS result and dense-breast notation to determine urgency and next imaging step.
5. If indicated, coordinate breast ultrasound to characterize lesions (for example solid versus fluid-filled) or improve visualization.
6. If findings remain unclear or high-risk features exist, prepare and coordinate contrast breast MRI, including allergy and metal-safety screening.
7. When tissue diagnosis is required, prepare for biopsy approach (for example core needle, surgical biopsy, or lymph-node sampling pathway).
8. Ensure specimen routing and documentation are complete, then escalate results to provider and navigation team promptly.
9. Provide staged patient teaching and repeat key information as needed during high-stress periods.
10. Link patient and family to counseling/support services and schedule definitive follow-up without delay.

Common Errors

• Delayed follow-up after abnormal screening → risk of stage progression before treatment begins.
• Incomplete MRI safety screening → contrast or implant-related safety events.
• Weak handoff/documentation between imaging and biopsy teams → missed or delayed diagnostic closure.
• One-time education during shock phase only → poor retention and low adherence to next steps.

Related

• breast-cancer-care - Integrates screening and diagnosis into full treatment and survivorship planning.
• therapeutic-communication - Repeated plain-language counseling improves decision quality during diagnostic uncertainty.