With the increasing utilization of mammography, young women under the
age of 35 are being referred for mammographic examination more frequen
tly. A review of the mammograms of 159 consecutive patients aged under
35 was conducted to evaluate the clinical value of the examination in
the age group for whom the probability of malignancy is low. 74% of p
atients referred had no discrete palpable mass and presented predomina
ntly with lumpy or tender breasts, the remaining 24% had a discrete pa
lpable mass. In neither group did radiographic examination beneficiall
y influence clinical management. We propose protocol where no imaging
is performed in women under 35 in the absence of a palpable mass unles
s there is a localized bloody discharge or a strong family history or
previous personal history of breast cancer. In patients with a palpabl
e mass, ultrasound should be performed initially to identify simple cy
sts and if negative only then progressing to mammography.