Women age 35 and older

• Breast cysts in older women can be managed similarly to those in younger women except that mammography is part of the initial work-up
• Solid masses should be excised if they are suspicious for malignancy either by clinical breast examination or by mammography, or if they are not seen on mammography.
• Masses that are not suspicious can be excised, biopsied with a core biopsy needle, or managed according to the triple diagnosis protocol. There is a 1% chance of missing cancer by this approach
• Women who have had a non-palpable breast lump identified on screening mammography need to undergo ultrasound to determine if it is cystic, and stereotactic or ultrasound-guided breast biopsy for histologic diagnosis.