What happens if your mammogram is abnormal?

March 30, 2021 | by Heidi Eklund, MD

Mammograms, or X-rays of the breast, help save lives by detecting cancer early. These screenings can locate breast tumors not found by breast exam — before physical symptoms develop.

Doctors generally recommend annual mammograms starting at age 40, but possibly earlier and/or more frequent based on your individual risk factors.

While you may be used to getting these screenings, you may not be prepared for hearing your mammogram was abnormal.

If this happens, don’t panic. It’s not uncommon and many times abnormal findings on a mammogram are not breast cancer. Your doctor will likely schedule follow-up tests to get more information.

Keep in mind, if you recently had the COVID-19 vaccine, a possible side effect of the vaccine is temporarily swollen lymph nodes on the side where you got your shot. This may show up on a mammogram and result in a call back for additional breast imaging which otherwise would not be necessary. Make sure your doctor is aware if and when you had your COVID-19 vaccine.

The following follow-up tests are often used alongside mammography when results are inconclusive or additional information is needed:

  • Diagnostic mammogram– includes more images than a screening mammogram to rule out breast cancer in a woman who has a lump, symptoms of disease or is identified as high risk.

  • Breast ultrasound – uses sound waves to obtain images of the breast. For women with dense breasts, whole breast ultrasound can be a supplement to mammography to detect small cancers that mammography may miss.

  • Breast MRI (magnetic resonance imaging) – uses strong magnetic fields to generate detailed images of the breast. Before the test, an IV is placed so that a contrast agent can be given by vein during the procedure, which helps reveal any potentially cancerous breast tissue.

  • MBI (molecular breast imaging) – generates functional images of the breast and involves an injection with a small amount of a molecular tracer, which differentiates cancer cells from normal cells.

  • Biopsy removal of cells or tissue from the suspicious area of the breast. The sample is then sent to a lab for analysis. According to the American Cancer Society, most biopsies (about four out of every five) are not cancerous. Some types of breast biopsies include:

    • Ultrasound guided core needle biopsy – sound waves are used to guide placement of a needle into the breast to retrieve samples of suspicious breast tissue or fluid.
    • MRI-guided core needle biopsy – removal of a sample of suspicious breast tissue using a hollow needle. MRI generates multi-planar and 3D images of the breast to locate the abnormality and guide the needle to the target areas.
    • Stereotactic core needle biopsy – a mammogram is taken to determine the exact location of the abnormality, then a biopsy needle with vacuum suction removes the suspicious breast tissue. Elmhurst Hospital is now offering AFFIRM® Breast Biopsy Guidance System, with 3D™ breast biopsy capability (coming to Edward Hospital in 2021), which helps reduce compression time and lowers X-ray dose for a better patient experience.
    • Surgical biopsy – removal of all or part of a breast lump, and possibly a surrounding margin of normal breast tissue, for further analysis.
    • Lymph node biopsy – used to check the lymph nodes under the arm for cancer spread. This may be done at the same time as a biopsy or breast surgery.

Follow-up tests may show a benign growth, calcification or breast condition like a cyst. Calcifications may be related to older age, past injury to the breast or an infection in the breast.

If there are no signs of cancer, you’ll likely return to your regular schedule of screening mammograms and breast exams.

If cancer is discovered, a breast cancer diagnosis will provide more information about the type and stage of the disease. Breast cancers found by a screening mammogram are often caught early, making treatment more successful.

At Edward-Elmhurst Health, our breast cancer imaging services include advanced tools, tests and procedures that rely on the latest techniques for a precise diagnosis.

Before starting treatment, you’ll be evaluated closely by a team of breast cancer experts from multiple disciplines. This is when all of your providers get together in the same room to closely review your imaging tests and biopsy results and determine the right treatment path for you. Throughout your care, the team continues to meet weekly to review your progress.

If your biopsy results are positive, you'll receive more detailed next steps, such as an appointment at the Breast Biopsy Results Clinic to meet with a radiologist and a breast nurse navigator and discuss a plan of action.

Learn more about the Breast Cancer Center at Edward-Elmhurst Health.


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