What Happens When You Get an Abnormal Mammogram?

There are few things that create anxiety quite like being called back after your screening mammogram because something appeared unclear or abnormal. Your mind immediately goes to breast cancer and you start to envision what may lie ahead. Before you jump too far into the future, it’s important to stay grounded in the present, take a breath, and better understand what your next steps may involve.

First Things First: A Look at the Mammography Call-Back Data

There’s no doubt that getting a phone call asking you to come back for further testing following your screening mammogram is a scary thing. But it doesn’t mean you have breast cancer. Approximately 10% of women are called back for further imaging. However, according to the American Cancer Society, fewer than one in 10 women called back for another look turn out to have cancer.

Something may appear abnormal in your mammogram for many reasons. Here are a few:

• An unclear image that may just need to be taken again
• A first mammogram: If this is your first mammogram, the radiologist may need a closer look since there is no previous mammogram for comparison.
• Dense breast tissue, which can make it harder to see parts of your breast
• Simple cysts, or fluid-filled sacs in thin walls that are not cancer
• Calcifications, or tiny calcium deposits, that may or may not be caused by cancer
• Solid masses: These are more concerning but most are not cancer

Diagnostic Mammograms

A screening mammogram looks for signs of breast cancer in women who have no symptoms of breast disease—which is most women—and can begin at age 40. If you are called back for a follow-up appointment because of a change or abnormality in your screening mammogram, a diagnostic mammogram will likely be recommended.

Diagnostic mammograms are mammograms acquired using the same machine as screening mammograms, but may include specialized views. A radiologist (a doctor who specializes in diagnosing injuries and diseases using medical imaging) will make sure the technologist operating the mammography machine gets these additional views. 

Breast Ultrasound

Some women may also get a breast ultrasound, which uses sound waves to create an image of the inside of your breast. A breast ultrasound can show all areas of the breast, including the area closest to the chest wall, which may be hard to properly acquire with a mammogram.  

During your ultrasound, you will lie on a table while a technologist and/or radiologist passes a small handheld unit gently back and forth over your breast. A computer turns the sound waves into a picture on a screen. 

Magnetic Resonance Imaging (MRI) of the Breast

Depending on what the radiologist wants clarified from your screening mammogram or ultrasound, they may recommend a breast MRI. An MRI may also be recommended for women at high risk for breast cancer as part of their regular screening. 

During the painless test, you lie face down inside a narrow tube. The MRI uses radio waves (not X-rays) and strong magnets to make detailed pictures of the inside of your breast. This provides more clarity on imaging or clinical findings.

Getting Breast Cancer Test Results

You will likely learn about the results of your tests during your appointment. You may learn that the tests showed nothing abnormal and you can return to your regular mammography schedule. In some instances, the radiologist may recommend you have your mammogram sooner than usual to make sure nothing changes.

If cancer is suspected, a biopsy will be needed to confirm.

Breast Biopsy

Even if a breast biopsy is recommended, it still doesn’t mean you have cancer. Most biopsies do not show cancer, but this test is the only way to tell for sure. 

During the biopsy, a radiologist removes a tissue sample with a high degree of precision, guided by either the mammogram, ultrasound or MRI—whichever best visualizes the abnormal finding. The tissue is then studied under a microscope to look for cancer cells.

If your biopsy results show cancer, your doctor will then refer you to a member of the breast cancer treatment team, most commonly a dedicated breast surgeon. 

Waiting for Biopsy Results

It typically takes two to three business days to get your biopsy results. During that waiting time it’s normal to have feelings of fear, anger and sadness. Try to keep in mind that most breast changes are not cancer and are not life-threatening. It may help to talk with a friend, family member, counselor, or other women who have been through a breast biopsy. Don’t hesitate to reach out to get support through this difficult period. 

Also, know that in getting your mammogram, you took the best action possible to catch breast cancer early when most treatable. This is why it’s so important that women stay up-to-date on breast cancer screening and schedule a mammogram.