A 40 year-old female has a mass found on mammography. What is the most appropriate next step in management?

The most appropriate next step in the management of a mass found on mammography is to perform a fine needle aspiration. This procedure is essential in obtaining a sample of the mass tissue for cytological examination. It helps to determine whether the mass is benign or malignant without the need for a more invasive procedure, such as a core needle biopsy or excisional biopsy. Fine needle aspiration is often preferred in initial evaluations because it is less invasive, has a lower complication rate, and can provide quick results. Accurate diagnosis is critical for further management, as treatment strategies will vary greatly depending on whether cancer is present.

Other management options, such as genetic testing for BRCA mutations, may be relevant for individuals with a strong family history of breast or ovarian cancer but are not indicated as immediate next steps following the discovery of a mass. Serum CA-125 is primarily a tumor marker for ovarian cancer and not typically used in diagnosing breast masses. Radiation therapy is a treatment modality rather than a diagnostic step and would generally be indicated after definitive diagnosis and appropriate treatment planning if the mass were found to be malignant.