EEH: What happens if your mammogram is abnormal?

Mammograms, or X-rays of the breast, help save lives by detecting cancer early. These screenings can locate breast tumors not found by breast exam — before physical symptoms develop.

Doctors generally recommend annual mammograms starting at age 40, but possibly earlier and/or more frequent based on your individual risk factors.

While women may be used to getting these screenings, they may not be prepared to hear their mammogram was abnormal.

But abnormal mammograms are not uncommon, and many times abnormal findings on a mammogram are not breast cancer. The doctor will likely schedule follow-up tests to get more information.

If a woman recently had the COVID-19 vaccine, a possible side effect of the vaccine is temporarily swollen lymph nodes on the side where the shot was given. This may show up on a mammogram and result in a call back for additional breast imaging which otherwise would not be necessary. Women should make sure their doctor is aware if they received a COVID-19 vaccine.

The following follow-up tests are often used alongside mammography when results are inconclusive or additional information is needed:

• Diagnostic mammogram– includes more images than a screening mammogram to rule out breast cancer in a woman who has a lump, symptoms of disease or is identified as high risk.
• Breast ultrasound – uses sound waves to obtain images of the breast. For women with dense breasts, whole breast ultrasound can be a supplement to mammography to detect small cancers that mammography may miss.
• Breast MRI (magnetic resonance imaging) – uses strong magnetic fields to generate detailed images of the breast. Before the test, an IV is placed so that a contrast agent can be given by vein during the procedure, which helps reveal any potentially cancerous breast tissue.
• MBI (molecular breast imaging) – generates functional images of the breast and involves an injection with a small amount of a molecular tracer, which differentiates cancer cells from normal cells.
• Biopsy – removal of cells or tissue from the suspicious area of the breast. The sample is then sent to a lab for analysis. According to the American Cancer Society, most biopsies (about four out of every five) are not cancerous. Some types of breast biopsies include:
  • Ultrasound guided core needle biopsy – sound waves are used to guide placement of a needle into the breast to retrieve samples of suspicious breast tissue or fluid.
  • MRI-guided core needle biopsy – removal of a sample of suspicious breast tissue using a hollow needle. MRI generates multi-planar and 3D images of the breast to locate the abnormality and guide the needle to the target areas.
  • Stereotactic core needle biopsy – a mammogram is taken to determine the exact location of the abnormality, then a biopsy needle with vacuum suction removes the suspicious breast tissue. Elmhurst Hospital now offers AFFIRM® Breast Biopsy Guidance System, with 3D™ breast biopsy capability (coming to Edward Hospital in 2021), which helps reduce compression time and lowers X-ray dose for a better patient experience.
  • Surgical biopsy – removal of all or part of a breast lump, and possibly a surrounding margin of normal breast tissue, for further analysis.
  • Lymph node biopsy – used to check the lymph nodes under the arm for cancer spread. This may be done at the same time as a biopsy or breast surgery.

Follow-up tests may show a benign growth, calcification or a breast condition like a cyst. Calcifications may be related to older age, past injury to the breast or an infection in the breast.

If there are no signs of cancer, women will likely be advised to return to a regular schedule of screening mammograms and breast exams.

If cancer is discovered, a breast cancer diagnosis will provide more information about the type and stage of the disease. Breast cancers found by a screening mammogram are often caught early, making treatment more successful.

At Edward-Elmhurst Health, our breast cancer imaging services include advanced tools, tests and procedures that rely on the latest techniques for a precise diagnosis.

Before starting treatment, women are evaluated closely by a team of breast cancer experts from multiple disciplines. This team will get together in the same room to closely review a patient’s imaging tests and biopsy results and determine the right treatment path. Throughout the patient’s care, the team continues to meet weekly to review the progress.

If biopsy results are positive, patients will receive more detailed next steps, such as an appointment at the Breast Biopsy Results Clinic to meet with a radiologist and a breast nurse navigator and discuss a plan of action.

Learn more about the Edward-Elmhurst Health Breast Cancer Center at www.eehealth.org/services/cancer/breast-cancer-center.