13 Reasons for a Mammogram Callback

It's normal and expected to feel anxious about a mammogram, especially when waiting for results. Breast cancer is a leading cause of premature mortality among U.S. women, so most think getting a callback means they have cancer.

Rest assured, a follow-up exam or test does not mean you have breast cancer. Fewer than 1 in 10 people called back after an abnormal mammogram have breast cancer.

This article discusses many reasons for a fast or same-day mammogram callback and helpful tips to manage your nerves.

What to Expect If You Get a Mammogram Callback

A second mammogram, known as a recall, is a diagnostic mammogram almost identical to the first screening. The only difference is that the radiologist will take pictures of a specific area they found unusual on your initial mammogram.

Your healthcare provider may also suggest a breast ultrasound (or sonogram). This common noninvasive diagnostic test uses high-frequency sound waves to create digital images of tissue, glands, organs, and other internal structures. Sonograms can distinguish between solid masses and breast cysts.

If you have a family history of breast cancer or other factors that put you at high risk for breast cancer, a breast MRI (magnetic resonance imaging) may also be ordered, which helps detect tumors that mammograms may miss.

Reasons for a Mammogram Callback

Simply put, a callback means your radiologist needs to get a clearer image of your breast tissue to be sure you're cancer-free. To help ease any anxiety, familiarize yourself with some of the reasons you may have to get a second mammogram.

Inconclusive Results

Radiologists are looking for specific abnormalities when reviewing your initial mammogram results. You will be called back for additional imaging if anything looks similar to the following:

• Calcifications (common calcium deposits in breast tissue)
• Cysts (benign, noncancerous fluid-filled sacs)
• Solid mass
• Dense breast tissue (when breasts have less fat and more glandular and fibrous tissue)
• Asymmetry (an area of the breast that looks different from the rest)
• Skin thickening
• Retraction (areas of skin or nipple pulling inward)
• Focal distortion (something is pressing on tissue)

Having any one of these abnormalities doesn't necessarily mean you have cancer. A radiologist is simply tracking and identifying changes in your breast tissue.

First Mammogram

If this is your first mammogram, don't be surprised if you're called back for additional imaging. Even without abnormalities, your healthcare provider may want a clearer understanding of your normal tissue because they have nothing to compare it with. A callback on your first mammogram is especially common if you have dense breasts (having large amounts of fibrous or glandular tissue) or augmented breasts (having implants).

Unclear X-Rays

Despite a technician's best efforts, sometimes the images don't appear clear enough and need to be retaken. This may be the case if you have dense breast tissue.

Newer mammogram technology has been shown to help reduce callbacks. Check with your facility and ask if they used a 2D or 3D mammography machine. Updated 3D machines can more accurately see each breast from multiple angles, reducing the risk of getting images with overlapping tissue.

Medical History

If you have a family history of breast cancer or have had biopsies (even benign), your radiologist will be on high alert for any changes or abnormalities. You may experience a higher rate of callbacks from now on.

Weight-Loss Surgery

Studies show that surgical weight loss can increase breast density. Most people don't know they have developed dense breasts. It's not related to breast size or firmness (which is fat tissue). Instead, breast density measures glandular and fibrous tissue.

Breast density can lead to a callback because it looks white on a mammogram, masking or mimicking malignancies. Additional screening will help interpret abnormalities.

Managing Anxiety Before and After a Callback

Getting a callback after a mammogram can bring many strong emotions, such as anger, anxiety, fear, disbelief, and sadness. Research shows that people avoid medical care due to feeling nervous, even when they know it's best for their health.

Fewer than 1 in 10 people are called back after an abnormal mammogram has breast cancer. Most likely, your callback is to double-check something. Ask to speak to your radiologist over the phone to get all the information you can. They want to help you understand what was seen and why you need to return.

If you're anxious, schedule an appointment with a therapist or counselor to discuss your feelings. Connect with people in-person or online who have also been called back after a mammogram screening.

Next Steps Once You Have Your Mammogram Results

You'll typically chat with your radiologist and get a summary of the findings during your second mammogram visit. You may also leave with a plan, which includes:

• Continue with routine screenings: If a second mammogram clears up any questions, you can return to your regular mammogram schedule.
• Follow-up sooner than normal: It's still likely nothing to worry about, but to be safe, schedule another mammogram in six months to ensure nothing changes over time.
  
• Get a biopsy: You'll need a physical sample of the abnormality to rule out cancer.

Keep in mind that a breast biopsy is still not a cancer diagnosis. More than 1 million women get biopsies each year, of which 20% are malignant.

Summary

You may be called back to get a second (diagnostic) mammogram or additional testing to clear up any abnormalities or unclear results from your initial screening. A callback does not mean you have cancer. There are many reasons for a callback, such as unclear X-rays, calcification, dense breast tissue, and family history. Additional images often show the finding isn't cancer.

A Word From Verywell

It's always nerve-racking to get a call from your healthcare provider, expected or not. When it comes to mammograms, that anxiety spikes because of the high rate of breast cancer in our community.

The most important thing to remember is that you are setting yourself up for health and longevity by getting regular mammograms, giving yourself monthly breast exams at home, and talking to your healthcare provider about any breast changes.