What to Expect After a Mammogram

From Florida Hospital - Apopka

If you’ve ever had a call saying your doctor found something suspicious on your mammogram, it can be a scary time. Does it mean you have breast cancer?

Beth Joannou, RN and breast care program nurse manager at Florida Hospital, talks about what happens after you have a mammogram and what it means when you’re asked to return for more tests.

Beth Joannou, RN

A questionable mammogram doesn’t automatically mean cancer. “In fact, according to the American College of Radiology, about 10 percent (100 out of every 1000) of women are called back for more tests,” says Joannou. “Of these, maybe 20 women will be recommended for a biopsy and four will be found to have breast cancer. That's four women out of every 1,000 mammograms.

If you’re called back, our team understands you may be experiencing anxiety and we’ll do everything we can to answer your questions and make you feel as comfortable as possible, explains Joannou.

Your Screening Mammogram

Screening mammograms are read within a few days. First, the report is sent to the physician, and a few days later a letter is mailed to the patient advising her whether the mammogram is normal of if she needs to return for follow-up tests.

If You’re Called Back

Once you’re called back, someone will explain your next steps. Usually, these include a diagnostic mammogram, breast ultrasound or breast MRI.

Diagnostic Mammogram – Like your screening mammogram, a diagnostic mammogram is an X-ray of your breast. Your mammogram technician will concentrate on getting additional images of your breast from different angles.

Breast Ultrasound – A breast ultrasound uses sound waves to determine if your mass is a fluid-filled cyst or a solid lump. It can show all areas of your breast, including tissue closest to your chest wall, that’s hard to study with a mammogram. It’s also noninvasive (meaning your skin isn’t pierced), painless, and doesn’t expose you to radiation. You’ll lie on a table and a technician will use gel and gently move a transducer – a small handheld probe – across the tissue. A computer then turns the sound waves into a picture.

Breast MRI – A breast MRI may be performed, with a mammogram or other imaging procedure, if you’re at higher risk of breast cancer. It captures multiple images of your tissue, which are then combined using a computer, to generate detailed pictures. In some cases, it’s done after a biopsy tests positive for cancer, and your doctor needs more information about the extent of your disease.

At your appointment, your radiologist will explain the results and your next steps. Most likely you’ll be told one of three things:

The suspicious area isn’t benign (not cancerous) and you can return to having annual mammograms.

While the suspicious area is probably benign, you should have your next mammogram sooner than normal – usually in four to six months – to make sure nothing’s changed.

If cancer isn’t ruled out, you’ll need a biopsy to know for sure.

If You Need a Biopsy

If you need a biopsy, you’ll be connected with a breast imaging coordinator who will answer any questions you have. A biopsy doesn’t mean you have cancer, but it’s the only way to know for sure. During the procedure, a small amount of tissue or fluid is removed from the suspicious area.

There are several types of biopsies and most use a needle. The type performed depends on how suspicious the area looks, how big it is, where it is in the breast, how many areas are present, other medical problems you might have, and your personal preferences.

After the sample is collected, it’s sent to a laboratory to be examined by a pathologist. Your results should be ready in about three business days.

“Once your results are received, the radiologist will make sure it matches up with what was seen. If not, she may recommend another biopsy or a surgical procedure,” explains Joannou.

If Your Biopsy is Negative

“If your biopsy rules out cancer, the radiologist may recommend you come back in less than a year, often six months, for a follow up mammogram or ultrasound of the breast that was biopsied.

If Your Biopsy is Positive

If cancer is discovered, you’ll be connected with an oncology nurse navigator, who works with your primary care physician to help select a treatment team.

Says Joannou, “our nurse navigators are very experienced in breast cancer, and will answer your questions, connect you with necessary resources and specialists and guide you through your entire treatment journey.”

Sources: Florida Hospital, American Cancer Society