All previous studies emphasize the need for complete diagnostic imaging evaluation before a probably benign assessment is rendered ( 1). Three specific findings are validated as probably benign at baseline imaging (or when no prior comparisons are available): noncalcified circumscribed solid mass, focal asymmetry, and solitary group of punctate calcifications, with cancer yield ranging from 0.3% to 1.7% ( 2– 5). BI-RADS 3 (BR3) assessment is used for probably benign findings, for which short-interval imaging surveillance can be safely used (usually at 6, 12, and 24 months, if stable) instead of percutaneous tissue sampling ( 1). To standardize reporting, facilitate outcomes analysis, and reduce ambiguity in mammogram reports, the American College of Radiology (ACR) developed the Breast Imaging Reporting and Data System (BI-RADS). Difference in cancer yield was 0.51% (95% CI: 0.16, 0.86) between women with and women without prior comparison at the same age ( P =. 001) cancer yield for baseline calcifications was eight of 929 (0.86% ) versus 84 of 2999 (2.80% ) with prior comparisons ( P <. Cancer yield for baseline BR3 masses was 10 of 2111 (0.47% ) versus 47 of 3003 (1.57% ) with prior comparisons ( P <. Cancer yield increased with increasing age decile, ranging from 0.51% (six of 1167) in women aged 30–39 years to 4.63% (41 of 885) in women aged 80–90 years cancer yield exceeded 2% at and after age 59.7 years for baseline findings and at and after age 53.6 years for presumed new findings, although there was no effect on stage distribution. Of these, 43 628 women (median age, 55 years age range, 25–90 years) had adequate follow-up for analysis. Various outpatient surgical techniques are associated with reduced morbidity, but symptom relief may be less durable.A total of 1 380 652 (18.2%) women were recalled after screening mammography, of whom 157 130 (11.4%) were given a BR3 assessment within 90 days after screening.

Newer laser-based surgical techniques have comparable effectiveness to transurethral resection up to two years after surgery with lower perioperative morbidity.

Transurethral resection of the prostate often provides permanent relief. Limited evidence shows that the herbal agents saw palmetto extract, rye grass pollen extract, and pygeum relieve symptoms. Although 5-alpha reductase inhibitors have a slower onset of action, they may decrease prostate size and alter the disease course. Alpha blockers improve symptoms relatively quickly. Over the past decade, numerous medical and surgical interventions have been shown to be effective in relieving symptoms of benign prostatic hyperplasia. For men with mild symptoms, watchful waiting with annual reassessment is appropriate. A palpable nodule or induration of the prostate requires referral for assessment to rule out prostate cancer. Men with hematuria should be evaluated for bladder cancer. The initial evaluation should also include a digital rectal examination and urinalysis. The American Urological Association Symptom Index is a validated instrument for the objective assessment of symptom severity. The initial evaluation should assess the frequency and severity of symptoms and the impact of symptoms on the patient's quality of life. Acute urinary retention, which requires urgent bladder catheterization, is relatively uncommon. Typical presenting symptoms include urinary hesitancy, weak stream, nocturia, incontinence, and recurrent urinary tract infections. Benign prostatic hyperplasia is a common condition affecting older men.

Benign findings