The Truth About Call Backs

Here’s the scenario: Girl schedules mammogram. Girl gets mammogram. Girl receives a call back that she needs additional testing. Girl freaks out.

While this reaction to a call back is very common, additional testing call backs actually occur somewhat regularly, and usually just mean that an additional test needs to be performed in order to examine an area more clearly. This is most common in premenopausal women and in mammograms performed on a patient for the first time.


IMG_0574The Stats

If you are called back for a diagnostic mammogram or other testing following your screening mammogram, keep is mind that this does NOT mean you have cancer. According to the American Cancer Society, about 10% of women who have a mammogram will be called back for more tests. But only 8-10% of those women will need a biopsy and 80% of those biopsies turn out be benign. And less than 10% of women who are called back for more tests are diagnosed with breast cancer. Only 2-4 screening mammograms out of every 1,000 actually lead to a cancer diagnosis.

(Read more: So, What is a Mammogram? [Screening Vs. Diagnostic])


What Do You Mean, “Suspicious”?

Usually when a patient is called back for additional testing, it is because something suspicious has appeared on their mammography image and the area in question needs to be examined further in order to rule out cancer. In reading mammography exams, radiologists look for two possible signs of cancer: tumors (or mass) and calcifications. While both of these can often be benign, they are still worth being positively identified, as they can turn out to be markers of risk: women who display these symptoms are more likely to be diagnosed with breast cancer in the future than women who do not have these symptoms.

If you do display certain risk factors, it only means that you will receive that much closer attention going forward in order to detect cancer at its earliest stages, so that your chances of a cure are greater. Your doctor may also recommend a routine ultrasound or MRI in addition to annual screening or diagnostic mammograms.


Before Your Follow Up Exam

If you’re nervous before your follow up exam, there are a few actions you can take to help calm your nerves.

  • Talk to family and friends who have experienced the same procedures. This will give you an idea of what to expect and may reassure you when they share their story.
  • Write down a list of questions to bring to your appointment. This will help calm you down and give you the feeling of control. You can even bring along a person you trust to your follow up appointment so you can have another set of ears when asking your doctor these questions.
  • Schedule your follow up tests for as soon as possible to eliminate downtime, so you’re not spending weeks or months worrying whether you have cancer. Your exam location should try to get you scheduled as soon as possible, but check back with the facility to see if any cancellations occurred so you can get in even earlier.
  • Make sure the doctor/facility performing your follow up exam has your past mammogram results so they can be compared with your new mammograms. An abnormality like a tumor that hasn’t changed for a few years may be more likely to be benign.
  • Take a deep breath and know that you will have your results soon.  As we pointed out in The Stats above, the odds are in your favor, so try to relax as much as you can.

(Read more: Breast Health Questions to Ask your OBGYN/PCP)


GirlQuestionHeadKeep Calm and Come Back

There are a few different types of exams that you may undergo at your follow up appointment in order to determine whether an abnormality or suspicious area is cancerous:

  • A diagnostic mammogram is performed the same way as your initial screening mammogram, though it may last longer because more x-rays of the breast are necessary. For example, a specific area of the breast may be magnified in order to obtain a more detailed image.
  • A breast ultrasound is a painless, non-invasive exam that uses sound waves to determine whether a suspicious area is filled with fluid (such as a cyst) or solid (such as a tumor).
  • Magnetic resonance imaging (MRI) uses magnets and radio waves in order to create more detailed pictures of the breast. Breast MRIs are often ordered if your breast abnormality cannot be identified using mammograms and/or ultrasound alone, and are often prescribed for women with dense breast tissue.
  • A biopsy may be recommended based on your diagnostic mammogram findings. During a biopsy, a small amount of breast tissue is removed and examined under a microscope. Biopsies are typically performed on an outpatient basis and are often scheduled very soon after your initial follow up. Many women feel that biopsies are even less uncomfortable than a mammogram. Results are often available within a week.


Your Follow up Results

Radiologists are often able to interpret and give you the results of your follow up exam right away. After reviewing your results, the doctor may determine that your abnormality is not a concerning one, and to continue with annual routine mammograms. Alternatively, a follow up mammogram may be recommended in six months’ time, because although your abnormality may not be cancerous, it should be closely monitored for any changes. If you need additional tests or treatment, you may be referred to a breast specialist or surgeon.

Many women greet callbacks with often undue anxiety and fear. It is important to remember that the whole point of screening for breast cancer is to catch the disease early and increase your chances of survival. Being called back for any additional testing only serves to further that goal and keep you healthy.

Posted in American Cancer Society, Diagnostic Mammography, Screening Mammography

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