In approximately 10% of cases, additional exams are required after the screening mammogram so that your medical team can more closely investigate anything abnormal detected during the screening. In 90% of cases, these exams are normal and will not come back positive for cancer. These additional tests include:
- Additional views
These scans are taken from different angles to get a clearer view of certain parts of the image. - Enlargements
Mammogram images may be enlarged two times so that the radiologist can more clearly see the tissue structure and borders of any abnormalities (e.g., microcalcifications).
- Spot compression
These mammogram images compress a specific part of the breast. This lets the radiologist get a better view of the borders of the abnormality and verify that the abnormality detected during the screening is actually there.
- Ultrasound
Ultrasound is a medical imaging technique that, instead of radiation, uses very high frequency waves to produce images of tissue. An image is obtained when a probe is passed over the breast. Ultrasound can detect whether a mass is liquid or solid and whether it may require further investigation.
- Biopsy
A breast biopsy involves removing tissue for analysis to determine whether the mass is benign or malignant.
- Fine-needle aspiration
In this procedure, a very fine needle is inserted into the mass. If the lump is a cyst, liquid will generally be aspirated (i.e., sucked out). If the lump is solid, aspirated cells will be sent for analysis in a pathology lab. This exam may be done by the radiologist or surgeon at a hospital or at his or her office. - Core needle biopsy or mammotome biopsy
This procedure involves removing a piece of the breast (a core) with a very large-diameter needle. A core biopsy is usually done under local anesthesia by a radiologist. It can also be done with ultrasound or stereotaxy (i.e., a kind of GPS that locates targets in the body). Ultrasound lets the doctor locate the area where the biopsy needs to be performed.
When the biopsy is done with stereotaxy, you will lie on your stomach on a special table with holes for your breasts. The radiologist locates the lesion with X-rays connected to a computer and then conducts the biopsy.