What happens if my mammogram is abnormal?

It's common to have an abnormal mammogram, says Paige Pennebacker, MD, from Blake Medical Center. Watch this video to learn about the steps a patient must take after receiving an abnormal screening.
Courtney Garlick, MD
Diagnostic Radiology
If your mammogram is abnormal, you return for a diagnostic mammogram. Abnormal findings don't always mean cancer -- and it's a circumstance that occasionally happens for first mammograms since the doctor doesn't have previous exam results for comparison. A return visit offers a follow-up analysis of the findings. Often the abnormal findings are resolved after this second meeting.

No matter the results, or identified risk level, mammograms should become a yearly routine. If risk does become reality, with a mammogram you discover it early, thus beginning treatment early and improving chances of success. Even if you're not considered high risk, it doesn't preclude you from an annual screening.

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Kathleen V. Greatrex, MD
Diagnostic Radiology
If your mammogram is abnormal, or if doctors spot something suspicious during a mammogram, they want to find out: Is it a solid something or is it a cyst? If it’s a cyst and it fills the criteria of a cyst, then it's almost 100% certain that it’s a benign process. However, if it is solid on ultrasound, more than likely your doctor will recommend a biopsy.

There are a lot of ways to evaluate areas that are asymmetrical in the breast; that are questionable -- either the woman feels it or it shows up on the mammogram. Ultrasound has proven to be quite a simple procedure. No radiation is associated with an ultrasound, but it's a way to to deduce whether something is a cyst or a solid mass. There is also ultrasound-guided core biopsy under ultrasound guidance, which is also very simple to do as opposed to other ways biopsies are done.

Another way to evaluate women when something is not quite right is magnetic resonance imaging (MRI). An MRI is a great modality for evaluating soft tissue masses to deduce whether it is a benign process, like a fibroadenoma or a malignant process.  MRI is another modality besides ultrasound.
Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
If your screening mammogram is abnormal, further mammographic views are performed; this is called diagnostic mammography. Additionally, ultrasound may be used to detect abnormalities in the breast tissue if any abnormalities are detected during a mammogram. If on diagnostic mammography and ultrasound of the breast, the abnormalities persist, a biopsy may be recommended.

If you receive an abnormal mammogram result, don’t panic. The numbers are in your favor. At least 70% of biopsies are benign with no further work-up needed. And, even with a breast cancer diagnosis, most cancers are successfully treated. Early detection leads to better survival, so remember to start your screening at age 40 and continue on a yearly basis.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
If you are told you are being called back for an abnormal mammogram, remember that most of the time, no cancer will be found. If you have to face a decision about a biopsy, ask your doctor whether the risk is very low (in the 2-10% range) or much higher. Ask whether they are worried about invasive cancer or Ductal Carcinoma In Situ (DCIS). If the risk is low, and they are mostly worried about DCIS, you might want to ask if there is an option to have close surveillance and come back in 6 months. Make sure they have compared your current image to your last one (what they are seeing now might have been there in the past and you might not need a biopsy).
Depending on what abnormality is seen, another mammogram may be done with more views than the initial screening mammogram. An ultrasound can also be used in some cases. A biopsy may be needed and there are different ways of getting a biopsy. Initially fine needle aspiration is usually done. This uses a needle to aspirate a sample of the mass.
An abnormal mammogram means that the radiologist has identified a "finding" on your mammogram. This abnormality will require further evaluation. The vast majority of such findings are benign, or non-cancerous.

Additional tests to evaluate irregularities in breast tissue include special mammographic views, ultrasound, and biopsy. In breast ultrasound, the radiologist uses sound waves (rather than x-rays) to produce images of the breast. With these images the radiologist can determine whether a lump seen on the mammogram is a non-worrisome fluid-filled cyst, or a solid mass or complex cyst, which may require additional attention.

Lumps that are solid (non-cystic) often require biopsy to determine their origin. In a biopsy, tissue is removed from the lump and the surrounding area of the breast, and is tested for malignancy. Biopsy may be performed with a large-gauge needle or by surgical incision, depending on the indications and patient and physician preferences.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.