Mammogram Follow-up Exams

What happens after a "suspicious mammogram"?

Learning that the results of a mammogram are suspicious and require follow-up tests is not easy. At Marshall, we've implemented a protocol rooted in speed and accuracy to reduce the wait time between follow-up exams and answers. In most cases, we're able to schedule follow-up tests the same day.

Below you'll find a summary of the various tests and follow-up procedures that may be indicated following a suspicious mammogram.


You may need an ultrasound.

A breast ultrasound uses reflected sound waves to view the internal structures of the breast. It can show all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. A breast ultrasound helps determine whether a breast lump is filled with fluid or is solid. An ultrasound generally does not replace the need for a mammogram; it is often used to further evaluate and complement was has been seen on a mammogram.

We may need to obtain a breast tissue sample.

There are several methods used to obtain a tissue sample, also known as a biopsy. Your doctor will consider a number of factors to determine which method is most appropriate for you, including the results of prior exams and the type of breast tissue you have.

Fine Needle Aspiration

Fine Needle Aspriation (FNA) biopsy is a commonly used procedure that involves placing a very thin needle inside the abnormality and extracting cells for microscopic evaluation. Ultrasound is used to precisely locate the abnormality. The procedure itself takes only seconds, and the minor discomfort is comparable to a blood test. The doctor will take a sample of the abnormality with a thin needle held in a needle holder. Two or three samples from the abnormality are typically required in order to provide an accurate diagnosis. Each sample will only take about 10 seconds to obtain and the whole procedure, from start to finish, generally takes no more than 90 minutes.

Core Needle Biopsy

Another option is a core needle biopsy. This is a safe, proven and minimally invasive form of breast biopsy that spares most women the discomfort, scarring and recovery associated wtih a traditional surgical breast biopsy. With the help of a local anesthetic, a hollow needle is used to extract multiple thin cores of tissue. This outpatient procedure is generally completed in 60 to 90 minutes. Patients can return to their normal daily activities immediately with little or no scarring.

There are two types of core needle biopsy. The difference between the two is the way in which the abnormality is located to precisely direct the needle, either with X-rays or ultrasound. Breast tissue varies a great deal and your physician will choose the method that will provide the best image for directing the needle. The two methods are:

Stereotactic Breast Biopsy:
- This is often used when abnormalities are seen, but not felt. Two X-ray images of breast tissue are taken at different angles to find the abnormality and calculate its precise location. The computer guides the physician in placing a hollow needle precisely into the abnormality.

Ultrasound Guided Breast Biopsy:
- Ultrasound guidance is often chosen when the original findings were from an ultrasound and when the best tissue visualization would indicate a need for ultrasound. This procedure uses the same biopsy technique as Stereotactic.

Wire-guided with Surgical Biopsy:

Sometimes, when an abnormality is found, the patient or her doctor may decide it is best to remove the entire abnormality as soon as possible rather than taking a small sample and waiting for results. This is commonly done as an outpatient surgical procedure. First, mammogram or ultrasound equipment is used to pinpoint the abnormality. Next, with the help of a local anesthetic, a very thin wire is inserted into the abnormality. This wire is used to guide a surgeon to the exact location of the abnormality, so that it can be completely removed.

What if the abnormality is found to be cancer?

Marshall's Cancer Services are fully accredited by the Commission on Cancer of the American College of Surgeons, and has a wealth of treatment options and support. Visit our Cancer Services page for complete infomation.

Please note: If you have children under 12 years old, please make other arrangements for childcare, as there are no childrecare facilities on site. Children under 12 may not be left unattended in the waiting areas. Due to the nature of the types of imaging exams performed and for safety purposes, children are not allowed in the examination rooms.