Ultrasound, why?

March 3, 2012 2:31 PM

Question about follow-up mammogram and ultrasound.

I had a mammogram. A few days later I did not get test results, but a request to have a follow-up and ultrasound. I called the doctor and asked why. He said the only information he had was that the radiologist wanted a "better view." There was no suggestion that there were any abnormalities.

I am 54 and I have small un-dense breasts, why do I need an ultrasound? I asked my doctor and all he said was that the radiologist requested it. I hate answers like that, I am a scientist, I need to know the exact reason why.

Odd thing is the follow-up tests are not until May. So if I have cancer, wouldn't they want to look at it sooner? Or is waiting normal? I am thinking this is nothing. But I find it odd that there is a request for a ultrasound. Any insights? Anyone experienced this? I will call the radiologist on Monday, but now I am looking for personal insights or experiences.

posted by fifilaru to health & fitness (11 answers total)

It's pretty straightforward. The radiologist couldn't see all the areas of your breasts that he/she needed to in order to conclude, unequivocally, that your exam was normal. Absolutely no need to be concerned at this point in time. Radiologists are cautious folks.
posted by killdevil at 2:47 PM on March 3, 2012 [2 favorites]

That happened to me. They explained the mammogram just wasn't as clear as they'd like, no obvious problem but just a shadowy area that could be caused by any umber of things including things just not being squished quite right. Ultrasound was fine.
posted by tamitang at 2:48 PM on March 3, 2012 [1 favorite]

Same here. I was able to reschedule my ultrasound appointment to a closer date. All was good. Call around and see if you can get your ultrasound done sooner.
posted by nimsey lou at 3:04 PM on March 3, 2012

Was it your first mammo? If so, it's easily explained: they want a thorough baseline for your file, so the ultrasound simply extends their view of your tissues. I had a mammo and then right away was sent to another clinic for a second mammo and an ultrasound with 4 or 5 different doctors and specialists peering at the screen – but I was fine.

Even if it isn't your first, what the others have said is true: they just want some clarification of areas that may not have been clear on the mammogram.
posted by zadcat at 3:05 PM on March 3, 2012

This happened to me also. First mammogram was a little ... blurry so they sent me in for an ultrasound since I had a family history to be reckoned with. Good thing about the ultrasound was that they told me right then and there "This looks fine, come back in six months" and there wasn't another agonizing "waiting for results" period.
posted by jessamyn at 3:17 PM on March 3, 2012

I've had two mammograms, and sonograms immediately after both of them. Both times, the mammogram was inconclusive and it was the sonogram that ascertained "oh, you just have a cyst" (as was the case both times).

The reasons why the mammogram didn't work were a) my breast tissue was too dense, and b) my boobs were just plain too small for the mammogram machine to get a good grip on. (You know you're in trouble when you open the gown and the tech takes a look at you and actually says "Oy."
posted by EmpressCallipygos at 3:29 PM on March 3, 2012

I read this thread to my wife who had a mammogram this past week. She insisted that I post the following comment from her:

"Having had 8 mammograms in the past 4 years plus 3 biopsies and no cancer (and no family history of cancer), I strongly suggest that, if possible, you use a breast center that has a radiologist look at the x-ray before you leave because the stress of waiting is agonizing. I also strongly believe that mammogram x-ray equipment shows such microscopic data that many women are having biopsies when fewer may actually be necessary."

And, to complete the story, she doesn't have to go back for 6 months (she is in her 50s and this seems to be her standard interval) and doesn't need a biopsy this time (if, indeed, she ever did). Sigh of relief.
posted by john2511 at 4:53 PM on March 3, 2012

I'm a bit of an expert, unfortunately, a veteran of many mammograms, ultrasounds and ... well, all the rest of it. I would push harder for a more definitive reason as to why they need the sonogram. "Better view" is too vague -- it is your right (and you are paying for it) to have a more definitive explanation. You can even ask to see the films! Have them explain where the bad view is! I would also push to understand why, if they didn't get a good look, they would wait until May for a follow up. I personally would not tolerate being put off in this manner, particularly at your age (which is my age too).
posted by thinkpiece at 5:24 PM on March 3, 2012

To start with, while it's not exactly your question, john2511's wife is right on. When I had a mammogram-followed-by-ultrasound-followed-by-biopsy a few years ago (ultimately, I was fine), they did the mammogram, then they did the ultrasound, then they did a stereotactic biopsy, all at once. It was Friday, which is the only reason I got the results Monday instead of getting them the next day. (Moral of story: No medical tests on Fridays.) I had it done at a Breast Center at a hospital where that's what they do -- somebody looks right away.

I would also echo those who have said that you're entitled to a better explanation, as well as those who say there probably is a good explanation and it's not anything to worry about at this point. As I understand it, there are indeed many, many reasons they need more pictures, or an ultrasound, or even a biopsy. Bad angles, shadows, plain old technical difficulties, an area that's hard to see ... I think sometimes that's one of the reasons they don't explain it enough -- they know how routine it is to need more information, and while they mean well, they forget that to you, it's never routine. Unfortunately, "better view" may really be the radiologist's real answer. I think it just means there's an area where the radiologist couldn't really see the tissue, and the radiologist may not even know what happened, whether it was bad compression or a bad angle or weird squishing or what.

I think you're well within your rights to wonder and want more answers, but I think there are many, many harmless reasons, including all those people have noted. Best of luck to you.
posted by Linda_Holmes at 7:03 PM on March 3, 2012 [1 favorite]

My baseline mammogram was followed up by an ultrasound within an hour to get a better view of one specific area, then they scheduled a needle biopsy for a couple days later and everything turned out fine. I guess this is a pretty common occurrence, but it sounds like you received poor communication and a delay in follow-up. I was in a major city at a prestigious medical center, so the quality of care may be different at places with different medical cultures.
posted by matildaben at 8:17 PM on March 3, 2012

Suggestion: ask your physician for a copy of the mammogram report if you are the sort of person that needs to know the details. Although the report will be written in doctor-speak, it will state the reason for the recommended ultrasound. It will say something like "there is a tiny area of increased opacity in X area, likely to be an artifact, but follow up with ultrasound is recommended in 6 months." (I'm completely making that up, but things like that are routinely said in radiology reports).
posted by treehorn+bunny at 9:56 PM on March 3, 2012