JAMA 311 (24): 2499 - 2507, 2014. doi: 10.1001 / jama.2014.6095 Diagnosis of Breast Cancer Screening by mammography, breast examination, and imaging (eg, ultrasonography) Biopsy, including analysis for estrogen and progesterone receptors and for HER2 protein Breast symptoms (eg, pain, nipple discharge) or abnormal findings (eg, mass) detected during breast examination are typically evaluated first with breast ultrasonography.