Q&A: Mammography Call-Backs

You’ve fol­lowed your physician’s rec­om­men­da­tion and had your year­ly screen­ing mam­mo­gram per­formed, but then you get called back for addi­tion­al imag­ing. Nat­u­ral­ly your ini­tial reac­tion caus­es your blood pres­sure to spike … this is a test that detects breast can­cer after all. How­ev­er, only 10% of women called back for more tests are found to have breast can­cer accord­ing to the Amer­i­can Can­cer Soci­ety. Learn more about call-backs and why it might not nec­es­sar­i­ly be cancer.

What is a call-back” mammogram?

A call-back mam­mo­gram is a fol­low-up to an ini­tial screen­ing mam­mo­gram. Call-backs mean that more imag­ing or an ultra­sound is need­ed to get a clos­er look at an area of con­cern. The point of the call-back is to pro­vide a thor­ough exam­i­na­tion of the abnor­mal­i­ty and for pre­cau­tion­ary mea­sures. Get­ting called back can be com­mon for women hav­ing their first mam­mo­gram due to lack of pre­vi­ous imag­ing for com­par­i­son or for pre-menopausal women that have dense breast tis­sue. An abnor­mal find­ing on a mam­mo­gram is not always cancer.

What else could the abnor­mal­i­ty be?

An abnor­mal find­ing on a mam­mo­gram can be dense breast tis­sue, over­lap­ping tis­sue, cyst, or non-can­cer­ous mass. In oth­er instances, if there is an abnor­mal or sus­pi­cious find­ing, the rou­tine screen­ing mam­mo­gram images might not pro­vide enough detail for the radi­ol­o­gist to make an accu­rate diag­no­sis or because there are no pre­vi­ous mam­mo­grams to com­pare. With the new imple­men­ta­tion of 3D mam­mog­ra­phy, radi­ol­o­gists are able to view your images bet­ter than ever before. This slice-by-slice” imag­ing allows radi­ol­o­gists to see each sec­tion of the breast, which has been shown to decrease the num­ber of call-back requests.

What will hap­pen at the call-back appointment?

Gen­er­al­ly a diag­nos­tic mam­mo­gram is request­ed by the radi­ol­o­gist. Diag­nos­tic mam­mo­grams include more images of the breast at var­i­ous angles (depend­ing on abnor­mal­i­ty loca­tion) to con­cen­trate on a spe­cif­ic area. A radi­ol­o­gist will be on-hand to advise the mam­mog­ra­phy tech­ni­cian, to ensure all the nec­es­sary images are cap­tured to eval­u­ate the abnormality.

Addi­tion­al­ly, the radi­ol­o­gist may request a breast ultra­sound and/​or a breast MRI for a more spe­cif­ic view. This varies from patient to patient.

After your call-back exams are com­plet­ed, the radi­ol­o­gist will speak to you regard­ing the results. If the radi­ol­o­gist can­not rule out can­cer from the addi­tion­al exam, gen­er­al­ly a biop­sy is rec­om­mend­ed for fur­ther analysis.

What if I need a biopsy?

If a breast biop­sy is deemed nec­es­sary, it still does not mean you have can­cer. Sta­tis­tics show most biop­sy results are non-can­cer­ous; how­ev­er, a biop­sy is the most accu­rate method to ensure the abnor­mal­i­ty is not can­cer­ous. Dur­ing the biop­sy, tis­sues around the abnor­mal­i­ty are numbed and a small tis­sue sam­ple is tak­en for micro­scop­ic exam­i­na­tion. After the tis­sue sam­ples are removed, a small met­al clip is placed in the breast where the tis­sues were biop­sied. The clips iden­ti­fy exact­ly what areas of the breast were biop­sied. Addi­tion­al­ly, for future mam­mo­grams, the clips show that a pre­vi­ous biop­sy was per­formed in that area. Clips gen­er­al­ly stay in for­ev­er unless sur­gi­cal­ly removed, are made of tita­ni­um and are about the size of a sesame seed.

Breast tis­sue sam­ples are sent to a lab where a pathol­o­gist will exam­ine them under a micro­scope and make a diag­no­sis. Biop­sy results can take up to 14 days to com­plete. Once your physi­cian receives the results, you will be contacted.

What hap­pens if can­cer is identified?

If can­cer or pre-can­cer­ous tis­sue is iden­ti­fied, you will be referred to a breast sur­geon who will review your med­ical infor­ma­tion and rec­om­mend an indi­vid­u­al­ized treat­ment plan. You will also be con­tact­ed by a nurse nav­i­ga­tor who will be able to assist with a myr­i­ad of care aspects includ­ing sched­ul­ing appoint­ments to help­ing you under­stand your care options.

Call 630−545−7880 to sched­ule your mam­mo­gram today. To sched­ule an appoint­ment with a breast sur­geon, please call 630−790−1700.