After a recent mammogram, the hospital called and asked that I come back in and have an ultrasound done on my right breast. This breast was found to have a lump in it around the 10 o'clock position. Both my doctor and I could feel the lump. He did put a needle in and drew some fluid which he sent out for testing. My question: Is it normal to have an ultrasound done after a mammogram? If so, why, and what are the appropriate follow-up steps?

--Karen

The follow-up you describe sounds normal and appropriate. If a mass is seen on mammogram, and it is unclear from the mammogram whether it is solid or cystic (fluid-filled), then an ultrasound is done to make that determination. Generally speaking -- and I caution that this is a gross generalization -- cystic masses are more often benign (non-cancerous), while solid masses have a higher potential of being malignant (cancerous). If a cyst is seen it is very easy to drain it using a needle under ultrasound guidance (this is called a needle biopsy). In general, if the fluid extracted is clear, yellowish, green or greenish-black, it is likely to be benign; a lab test can confirm that. Bloody fluid is more worrisome and should definitely be sent to the lab for further evaluation.