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7% (4/46) of masses and 8.9% (9/101) of focal asymmetries were malignant. Cancers were associated with older age (mean 65.2 vs 52.7 years, p 0.001), smaller size (mean 9.5 mm vs 15.5 mm, p 0.01), and concurrent breast cancer (p 0.01) compared to benign/high-risk lesions. Multivariable logistic regression model using patient age 50 years, lesion type, and size 15 mm had a high diagnostic performance [AUC=0.89, 95%CI (0.83, 0.94)], and yielded the highest PPV [0.24; 95%CI (0.13, 0.38)], and highest number of avoided,