Abnormal Mammogram – what now?

Posted on 30 September 2020

Dr Lucienne van Schalkwyk, Specialist Breast Surgeon at Mediclinic Sandton brings us some insight into what an abnormal mammogram could mean.

She explains, “Usually a scheduled mammogram goes off without a hitch. But when it doesn’t – when we are informed that something abnormal has been picked up – our first (understandable) reaction may be panic. An important fact to keep in mind in this situation is that very often “abnormal” findings on a mammogram are not cancer.”

If the radiologist is unsure of the significance of the abnormal area, he/she may take a few additional mammogram images to get a better look at the area, or place compression on a specific area (referred to as spot compression views) to see whether the finding is due to overlapping breast tissue (which usually vanishes on compression). In addition, an ultrasound may be performed to further characterise the area.

Dr van Schalkwyk continues, “You may also be referred for an MRI scan of your breasts, which supplies high resolution, detailed images of the breast and can help the radiologist to decide how serious the abnormality is.”

“If your radiologist determines that the abnormality is most likely not cancerous, he/she may ask you to return for a short interval follow-up, usually after 6 months. A limited examination is performed (e.g. mammogram of only the affected breast with an ultrasound of the abnormal area) and compared to the previous image to see if the area has changed. If it hasn’t, another mammogram and ultrasound is performed in another 6 months’ time (in other words, one year from the first examination) and if it still hasn’t changed in any way, routine breast examination can be resumed,” explains Dr van Schalkwyk.

She cautions, “In some cases, a biopsy of the breast may be recommended. Usually, this is performed by the radiologist under local anaesthesia using a biopsy needle, which removes a small piece of tissue from the abnormal area. The radiologist uses the ultrasound or mammogram to guide them to the area to be biopsied, ensuring that the correct area is sampled. Thanks to the local anaesthetic, the process should be painless and you can continue as normal with your day afterwards.”

Some women experience bruising of the breast, which usually disappears after about a week. After the biopsy has been performed, the radiologist will discuss aftercare of the biopsy site, as well as when and where to obtain the results.

“Further steps would depend on the results of the biopsy. As mentioned, many abnormalities prove to be non-cancerous and may safely be left alone. If the biopsy has diagnosed a cancer, your radiologist or GP will be able to refer you to a specialist multidisciplinary breast cancer management team (consisting of general surgeons, reconstructive surgeons, oncologists, pathologists etc.) who will be able to advise you and support you going forward,” concludes Dr van Schalkwyk.

The important thing to note is that with each of these interventions, the doctor is able to make a more accurate and early diagnosis, allowing for the best possible clinical outcomes.

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