My mammogram is abnormal, now what?
Why am I getting called back?
If your mammogram was found to be abnormal, that means your breast tissue has changed. After the radiologist reads your mammogram, you may need additional testing to determine what the changes are. Are there calcifications or a mass? Is there a cyst or a solid mass? If you have dense breast tissue, is the white area dense tissue or cancer? (Because they both appear white on a screening mammogram) A call back will help them answer these questions.
What is the next step?
During your 2D/3D digital mammogram screening, the tech captured two x-ray images of the breast, one from the top and one from the side. These are flat, 2-dimensional images. The 3D digital mammogram is an imaging system that arcs over the breast for several images. Depending on the availability of 3D mammography, you may have had a 2D, a 3D, or a combination 2D/3D mammogram screening. If you look at the label on your paperwork, you will know which type of mammogram screening you received.
If you have an abnormal screening, your next step will be a diagnostic mammogram. This will be an 3D mammogram which is a digital arcing over the breast. The tech will capture several images 100-200 for the radiologist to review to determine if the suspicious area needs further testing. These images will slice and dice the breast, figuratively speaking, so that the radiologist has more images to determine if you have dense breast tissue and/or cancer.
If the diagnostic mammogram is inconclusive, you may be asked to schedule a full breast ultrasound. This is an additional tool to help determine if the abnormality is solid or fluid filled. A solid mass may mean a non-cancerous lump of tissue or a cancerous tumor. A fluid filled mass usually is benign.
If the ultrasound is inconclusive, you may be asked to schedule an MRI. An MRI is a very sensitive imaging system that can pick up the smallest of abnormalities regardless of the density of the breast tissue.
If your results do show calcifications or a solid mass, you may be asked to schedule a breast biopsy. A breast biopsy includes a small retrieval of tissue so that it can be tested for cancer. Ultimately, a breast biopsy is the only test that can determine if you have cancer or not.
What if it is cancer?
If you are diagnosed with cancer, you will need a referral for a breast surgeon. You will meet with the surgeon to determine your treatment strategy based on your diagnosis. Here are 4 things to help you prepared for your appointment.
Make a list of all the questions you have. Write them down, do not try and ask them from memory. Trust me on this, you will be overwhelmed and unable to recall all that you want to ask.
Take a family member or friend with you. A second set of ears is always the best when you are trying to remember and process all the information.
Ask if you can record the conversation. Again, so much information that needs to be processed and having a recording to play back will be very helpful.
If the physician or nurse uses words you don’t understand, ask them to explain it, spell it so that you can write it down and look it up for further clarification.
Use online resources that are credible. Not Dr. Google. The American Cancer Society, American College of Radiology, National Cancer Institute, etc. These organizations have statistics and scientific evidence to back up what they put on the internet.
Over the last 12 years, while serving many people walking through cancer, these are the questions I get on a weekly basis. My hope is by removing the fear and anxiety about breast health, I can help educate you and empower you to be your own advocate for your breast health.
Your Breast Friend,
Edie