Diagnostic workup
There is no doubt regarding the importance of mammography and sonography as the first steps of evaluation of a breast lump. However, as usual, these tumors would present similar to the benign lesions on these modalities (2,31,32), some other evaluation may be needed. In the case of evidence for PBOS on core needle biopsy, in addition to the routine workup of breast cancer, some other assessments such as bone scan and serum alkaline phosphatase activity are recommended by some authors (33,34,35). Furthermore, there is a suggestion to use serum alkaline phosphatase activity for follow-up and monitoring purposes (35). MRI has been used for additional evaluation and information; meanwhile, Dynamic Contrast-Enhanced Magnetic Resonance Imaging, Diffusion-Weighted Imaging Findings, and Proton Spectroscopy have revealed novel findings(36).