Abnormal Mammogram Evaluation- Should you be notified by the radiologist that you have an abnormal mammogram you will be referred to a breast surgeon for further review. This involves the breast surgeon reviewing the mammogram with the radiologist and discussing the findings with you. From this it will be determined what next steps are required to further determine the extent and nature of the abnormal findings.
It is important to note that while mammography is a great diagnostic tool it is not perfect. The American Cancer Society reports that one out of ten women who get a mammogram will have abnormal findings. These women are then scheduled for more detailed imaging. Out of this group only one in ten will require a tissue biopsy of which 80% of the results are benign.
If you have been told by either a radiology facility or your primary doctor that you need a breast biopsy please understand that you will likely NOT have the biopsy the first time you see the doctor. Sometimes the doctor is able to do a biopsy on your first appointment but this rarely happens. The first appointment is for a consultation to review your mammograms and ultrasound and for the doctor and you to make a decision as to whether a biopsy is needed and, if so, what kind of biopsy should be done. The doctor can perform some ultrasound-guided biopsies and surgical biopsies but does not perform stereotactic biopsies. To avoid frustration, misunderstanding, and disappointment we encourage you to schedule the recommended biopsy with the radiology facility and should the doctor be able to do the biopsy the day of your consultation the radiology appointment can be cancelled.
Many women wonder why they need to see a breast specialist doctor if the biopsy can merely be done by a radiologist. When a woman has an abnormal mammogram there is more to consider than just technically getting a biopsy. Often radiologists recommend a biopsy and once the imaging is reviewed with a breast specialist a recommendation is made for only a 6 month follow up mammogram. Sometimes after consultation with the doctor a different type of biopsy is settled on (for instance a surgical biopsy). Additionally, once a biopsy is done there is inevitably follow up imaging and follow up visits to be done and a breast specialist doctor is the best person to coordinate all that. Lastly, it is to your advantage to be examined by a breast specialist BEFORE any bruising or swelling obscures subtleties of your breast exam.
