Days after a routine mammogram you hear from your doctor. Something looked suspicious and you need to get rechecked. It’s natural to imagine the worst, but there’s no need to panic.
Take a deep breath and know that in the great majority of these cases, the suspicious spot isn’t cancer. A follow-up, known as a diagnostic mammogram, often means the doctor just needs to look at the breast in greater detail, said Veronica Jones, M.D., a City of Hope breast surgeon.
“The first screening mammogram is a quick look to see if further examination is needed,” Jones said. “The most common reasons for follow-up mammograms are abnormalities like dense breast tissue, cysts, benign growths or calcium deposits. A biopsy is performed only 10 percent of the time.”
Even so, a diagnostic mammogram can be quite stressful, but knowing what to expect — and taking the right steps to prepare — can help expedite the process and provide some peace of mind.
Veronica Jones, M.D.
If your previous mammogram was performed by a different health care provider, make sure your current doctor has a copy for a more accurate screening. If not, request a copy of the X-ray and bring it to your diagnostic appointment.
“Bring it along so the doctor has something to compare to the new image,” Jones said. “If no changes are found in the new mammogram, a follow-up probably won’t be necessary.”
Also, be sure to have a discussion with your physician to see if you’re at high risk for breast cancer. That way it can be determined how often you should get screened, and if additional or more thorough testing might be needed.
Factors that make you at high risk include a family history of cancer, previous ovarian cancer, known gene mutations, chest radiation if you had lymphoma as a child, or multiple biopsies for previous breast abnormalities,” Jones said. “It’s important to relate any of these factors to your physician.”
What to expect
Keep in mind that diagnostic mammograms usually take longer — it’s a more involved process than a screening. A number of images will likely be needed to get a clearer picture of the precise area in question. “And sometimes more tests, like an ultrasound or an MRI, are required before you get a final result,” Jones said.
In most cases, no evidence of cancer is found and the patient happily returns to a normal mammogram schedule. If results are inconclusive, another mammogram will probably be scheduled sooner, maybe within four to six months, to see if there are any changes.
And if a biopsy is needed? Take another deep breath. Most biopsies turn out to be benign, but it’s the only way to know for sure. After getting biopsied (taking a small amount of tissue with a needle, incision or other means), a patient often has to wait several days before a pathologist can make an accurate diagnosis.
Patients shouldn’t hesitate to get a second opinion at any point during the process if they’re uncomfortable and feel they need reassurance about the results, Jones said. Cancer specialists can often detect subtleties other physicians might miss.
Sometimes a second pair of eyes can be good to ensure that nothing is missed,” she said. “It does not necessarily have to wait until a biopsy is needed. Nothing is bulletproof, after all. Most people wait until breast cancer is diagnosed to get a second opinion.”
If you’re looking to go elsewhere, carefully consider your options — where you get a second opinion can make all the difference. A world-class medical center like City of Hope can provide access to the most advanced equipment and a highly trained staff for the most accurate diagnosis.
“City of Hope is a specialty cancer center, so tests are often interpreted by breast-trained physicians,” Jones said. “We have 3-D mammogram techniques, ultrasound and MRI, so if any tests are needed, everything is in one place. We also have specialists here who can treat whatever condition is found.”