Breast nodule below 25 years old - Maxwell criteria

Current recommendation (UK, Ireland) is discharge WITHOUT biopsy or follow-up for:
- Women <25yo and="" p="">- Breast nodule typical of fibroadenoma on Ultrasound examination


Maxwell criteria for non-biopsy of solid masses in <25yo b="" female=""> (Maxwell & Pearson*)

Clinical features:
1. No known risk factors
2. Mass/nodule not rapidly enlarging
3. Smooth discrete mobile nodule / Impalpable

Sonographic features:
1. Well-defined, ovoid shape
2. Flat lesion, ie Height < Width
3. <3cm dimension="" greatest="" in="" p="">4. Smooth outline / Gently lobulated (2-3 lobulations) (NO microlobulations!)
5. Homogeneously isoechoic or slight hyperechoic, solid
6. Thin echogenic pseudocapsule
7. No calcification.
8. No posterior acoustic shadowing.


Reference:
* Maxwell AJ, Pearson JM. Criteria for the safe avoidance of needle sampling in young women with solid breast masses. Clin Radiol 2010;65:218-22