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).