Breast cancer risk is strongly related to age, with 80% of cases occurring in women over 50 years old. Small, benign-looking lesions in perimenopausal women have a very low risk of malignancy and are not recalled. We undertook an audit to assess the significance of a single, new, apparently benign (R2) lesion seen on both views on screening mammograms of women aged 60 years and above. Any new density with suspicious imaging was recalled without being entered into the audit.

A total of 70 women were included. Fifty-seven patients had no significant findings or cysts on ultrasound, with a normal postaspiration mammogram. Three patients had cyst aspirate sent for cytology, and one of these went on to have a core biopsy for a C3 result. Ten patients had a solid lesion on ultrasound warranting a core biopsy, two of which had a B5 lesion.

Although the majority of patients had a benign result, a total of three out of 70 patients had an abnormal cytology/histology. We recommend that new benign densities seen on two views in women aged over 60 years old are fully assessed and biopsied to determine their nature.