Mammograms are a crucial part of breast cancer screening, providing a powerful tool for early detection. There are times when patients may be called back after a routine screening mammogram.
Being called back after a mammogram may bring a lot of emotions. However, if you are called back after a mammogram, it does not mean you have breast cancer. In fact, it is unlikely.
Understanding the most common reasons for additional imaging after a mammogram can prepare you for the next steps if you are called back.
What Is a Mammogram Call Back?
A mammogram call-back occurs when a radiologist — a highly trained specialist in reading and interpreting mammograms — notices new or different findings, such as masses, calcifications, or asymmetries.
A call-back does not necessarily mean a cancer diagnosis. More than 90% of women called back for additional imaging are not diagnosed with breast cancer.
“The majority of mammograms we read are normal, but a small percentage of patients are called back for additional imaging,” says Amy Kelly, MD, breast radiologist with UPMC Magee-Womens Imaging. “If you are called back, it does not mean you have breast cancer. In fact, it is unlikely, and the majority of patients receive benign results when they return for additional imaging.”
A mammogram call-back does signal a need for further investigation. Those who are called back will be scheduled for a diagnostic mammogram — a more detailed view of the breast tissue to rule out potential issues.
How do a screening mammogram and diagnostic mammogram differ?
- Screening mammogram — An x-ray of the breast taken in patients without current breast problems or symptoms. They detect breast abnormalities, which may be signs of breast cancer not noticeable in a physical exam.
- Diagnostic mammogram — A more detailed breast x-ray than a screening mammogram. You may need a diagnostic mammogram if additional imaging is required after your screening mammogram.
Why You Might be Called Back After a Diagnostic Mammogram
Mammograms are highly effective in detecting abnormalities in the breast tissue, but most of the time, abnormalities are related to benign breast conditions.
Here are a few reasons why you may be called back for additional imaging:
Calcifications
Calcifications are common reasons for a mammogram call-back. They are tiny deposits of calcium that appear as white spots on a mammogram. Calcifications are generally benign (noncancerous) and can occur due to normal aging or after an injury to the breast.
A radiologist will carefully evaluate their shape, size, and pattern if they notice calcifications during a mammogram. If the calcifications appear suspicious or irregular, the radiologist may recommend further testing, such as a breast biopsy.
Asymmetry
Asymmetry in breast tissue refers to an area where one breast appears different from the other on the mammogram. This difference could be due to variations in the breast tissue’s size, density, or shape. Asymmetry is not uncommon; in many cases, it is simply a result of natural breast tissue variations.
A radiologist may recommend additional imaging to better understand the cause with asymmetry noted. Additional imaging could involve different mammographic views or an ultrasound to gather detailed views of the breast tissue and eliminate any concerning abnormalities.
Abnormalities in the skin or nipple area
Changes in the skin or nipple area can also lead to a mammogram call-back. For example, skin thickening or nipple discharge might indicate an underlying issue. These changes can sometimes be related to breast cancer, although many cases are benign.
If a mammogram reveals any unusual findings in the skin or nipple area, additional imaging or clinical examination is required. This allows the medical team to gather information and make an accurate diagnosis.
Masses
Sometimes, mammograms reveal a mass in the breast tissue. Most masses are benign — like cysts or fibroadenomas — but some may require further investigation to determine whether they are cancerous.
A mass might appear on the mammogram as a solid lump or a fluid-filled cyst. The radiologist will assess its size, shape, and location. If a mass appears suspicious, additional imaging or a biopsy to test the breast tissue is required. Early detection is essential for effective treatment, so further testing is typically recommended.
What to Expect After a Mammogram Call-Back
If you’re called back for additional imaging, it may be helpful to remember that most recalls don’t lead to a cancer diagnosis. It’s simply a precautionary step to ensure the health and safety of your breast tissue.
- Additional imaging — To get a more detailed look at the area of concern, you will likely be scheduled for a diagnostic mammogram or ultrasound. These tests are typically quick and non-invasive.
- Possible biopsy — If an abnormality is found, a biopsy may be necessary to determine whether the tissue is cancerous.
- Follow-up appointments — If something suspicious is found, your doctor will discuss the next steps. This could involve additional tests, monitoring, or a referral to a specialist.
If you are called back after a mammogram, stay informed, follow your healthcare provider’s recommendations, and remember that most recalls lead to benign findings. When you return for additional imaging, you will be given your results and recommendations before you leave. Understanding mammogram results and being proactive about breast health is vital for the best possible outcomes.
Editor's Note: This article was originally published on , and was last reviewed on .