Getting a mammogram is not usually high on a woman’s list of favorite things to do, but having it done-and-over-with provides peace of mind that is invaluable. That is, of course, unless you are called back for a re-screening. Right up front I’ll tell you that a “call-back” is not cause for panic. That said, however, if you receive a recall notice, it is of utmost importance to follow up with a second screening.
How often recalls happen
Studies show that there is a 1 in 10 chance of being called back after a screening mammogram. The second procedure, a diagnostic mammogram, takes a little longer because more images are captured, but the overall experience is basically the same. Knowing what to expect, however, can make it all less stressful.
The best anxiety reducer is knowledge. Only about 5% of recalls actually detect cancer. These statistics fluctuate depending on geography, modality used for the diagnostic mammogram, and other variables such as age and screening intervals.
Most call backs reveal no health problems. Often, a potential concern detected in a screening mammogram turns out to be nothing at all. In other cases, a diagnostic mammogram confirms benign breast disease only.
Why call backs happen
The screening mammogram produces images that are evaluated by trained medical personnel who can differentiate between “normal” breast tissue and suspicious tissue. Suspicious tissue may appear as a dark spot, a shadow or a line in the image. Because even normal breast tissue can be fibrous or dense, images are not always clear. Therefore, any image that doesn’t appear 100% normal can result in a call back.
Abnormal mammogram findings are categorized, and can result from a number of things. As mentioned earlier, benign breast disease could be present. Sometimes, however, the explanation can be as minor as movement when the image was captured, the angle at which the screening mammogram was taken, or simply an inaccurate reading.
Lowering call back rates
Breast imaging technology is advancing rapidly. Reducing call back rates is one of the objectives for developing better screening and diagnostic modalities. Full-field digital mammography (FFDM) is becoming more widely used for screening as it provides crisper images. Much work is also underway to explore the advantages of combining modalities such as FFDM and digital tomosynthesis and some studies indicate that call back rates can be reduced by more than a third. Breast Tomosynthesis takes imaging “slices” of the breast utilizing X-rays. This enhances the ability to see abnormalities in the dense breast tissue.
New technology in the Ultrasound modality is probably the hottest around. Automated Breast Ultrasound Screening is being used as another useful tool to diagnose breast cancer in dense breasts, especially in younger women that are too young to obtain a mammogram. A new technology called Automated Breast Tomography (“Sofia” is the name of the unit), allows the breast to be seen in 3D (slices) like digital tomosynthesis. Ultrasound requires no radiation. It should be used in conjunction with mammography and or MRI, as there is not one modality that covers everything. Utilizing many modalities provides you with the highest chance of diagnosing breast cancer at a very early stage.
What to do in the case of a call back
At the risk of sounding repetitive, the three most important pieces of advice if you receive a recall notice after a screening mammogram are:
- Don’t panic
- Schedule an appointment right away
- Ask if the use of other screening modalities in conjunction with mammography are a good option for you
If a friend or loved one receives a call back phone call or written notice, share the same advice. Knowing that a call back is relatively routine, you can also confidently support them through what could otherwise be an extremely stressful time.
Photo by grapejuicegirl on flickr