My mammogram is abnormal? Now what?

Nov 29, 2018

Every woman breathes a sigh of relief when she gets the word that her breast mammogram is normal. But what happens when you don’t get the all-clear? What happens when the radiologist sees something suspicious?

Getting called back for a follow-up can be a bit nerve-racking, but Kathie Edgington, a breast imaging specialist with USMD Imaging Center for Breast Health, explains it’s not necessarily bad news.

“Right off the bat, I try to alleviate any fears,” Edgington says. “There are several reasons you may get called back for additional breast imaging—and they don’t mean you necessarily have breast cancer. That’s why the breast imaging technologists or radiologist at USMD reach out directly to every woman, rather than have the call center contact her. That way we can schedule her appointment right away and answer any questions she may have as best as we can.”

Because mammograms can show cancerous growths in the breast up to two years before a woman or her physician can feel them, careful review, comparison and follow-up imaging are critical to early detection. Still, because every woman’s breasts are as unique as she is, caution plays a role in determining what is “normal” for each woman’s breasts—and sometimes a second closer look is the most prudent thing to do.

Here are some of the most common reasons women are called in for additional imaging following their mammogram:

First mammogram
A woman’s first mammogram—or baseline mammogram—is very important because it provides the radiologist with the first view of her breast tissue. Follow-up mammograms are compared to the baseline mammogram in order to identify any changes in breast tissue over the years.

“About 50 to 60 percent of women who have never had a mammogram get called back for additional imaging,” Edgington says. “That’s because we have nothing to compare the baseline mammogram with. If you get called back after your first mammogram, it’s because we want to establish what’s normal for you.”

“Our radiologist may see some microcalcifications in the breast tissue, which are like tiny grains of salt,” Edgington says. “Most of the time they’re benign, but we want to be sure so we do magnified views that enlarge the suspicious area so we can see them more clearly.”

With these magnified views, the calcification can be viewed more closely to determine if it looks benign or malignant.

Asymmetrical tissue
While no woman’s right and left breast are identical, there is usually a certain amount of symmetry between the two. If the tissue in the right and left breast looks different or asymmetrical, it may be flagged for closer inspection.

“The asymmetrical tissue may just be normal for that woman,” Edgington says,” but unless we have a prior mammogram to compare it with, we don’t know if it’s normal or not. If we do have a prior mammogram to compare it with, then we look for tissue that appears to be new or different.”

A 3-D image, ultrasound or both may be used to examine the tissue more closely—depending on the nature of the suspicious area. Unlike 2-D imaging, 3-D imaging captures pictures of individual tissue layers—allowing the radiologist to scroll through each layer and determine if the asymmetry is a cancerous mass or simply tissue that just happens to be clumped together due to a hormonal change or other non life-threatening reason.

Callback myths
You won’t get a call back because the mammography equipment didn’t capture a clear image of your breast. “Often women will tell me, Oh I just thought you called me back because the picture wasn’t very good,” Edgington adds. “The equipment we use now is so state-of-the-art that fuzzy images just don’t happen. It’s like a digital camera—we see the picture immediately. If a woman moves or breathes or disturbs the image in any way, we know it and take another image right then.”

Same-day results
If you are called back by the team at USMD Imaging Center for Breast for additional imaging, you won’t have to wait long for your results. “We don’t want any woman to worry needlessly about their results,” Edgington says. “You will know something that day.”

If the additional images still look suspicious, a biopsy may be recommend. “If a biopsy is recommended, we’ll schedule the biopsy appointment that day,” Edgington adds.

Because it’s equipped with state-of-the-art technology and staffed by highly experienced and compassionate imaging technologists and world-class radiologist, more and more women are coming to USMD Imaging Center for Breast Health. Even if you’ve had earlier mammograms at other facilities, you can request that your existing mammography film be transferred to USMD.

“Most facilities require a signed release before they will transfer mammograms,” Edgington explains, “but women can either call their old facility and request that their files be sent to USMD, or they can come by USMD and sign a release form and we’ll request the transfer for them that day,” Edgington says.

If you have questions or concerns about your breast health, the caring team at USMD Breast Health Center is here to help. Call us at 1.888.444.USMD.