Abnormal Mammogram? What To Do Next

7 min read

Abnormal Mammogram? What To Do Next

Regular breast cancer screening with a mammogram is proven to detect breast cancer at an early stage, making it easier to treat. Your gynecologist or primary care physician will usually help you find a facility that performs mammograms, but you ultimately have the choice of where to go. When your doctor receives the screening results, they can assist you with the necessary next steps. Learn more about breast cancer screening. 

Additional imaging is the most common next step when a mammogram shows an abnormality. It’s important to remember that an area of concern found in a screening mammogram is not a cancer diagnosis. It simply means more testing is needed to be sure—one way or the other. In many cases, the area of concern turns out to be noncancerous.

Imaging Tests Used for Diagnosing Breast Cancer

Several different options are available for more detailed images of the breast. The information collected from these images will determine if a biopsy is necessary. Some of the diagnostic imaging methods that can be used are:

  • Diagnostic mammogram: This type of mammogram is similar to a screening mammogram but involves taking more images, focusing specifically on the area of concern. Retaking the mammogram can help confirm whether something seen on the initial mammogram was just a shadow or fold in the tissue rather than a lump that requires further investigation.
  • Breast ultrasound: Ultrasound is a different type of imaging that can determine if a breast lump is a solid tumor or a cyst. Sound waves create images with a different level of detail than a mammogram or MRI. 
  • Breast MRI: MRI scans can provide additional diagnostic information after an abnormal screening mammogram. They use radio waves and magnets to create detailed images of the inside of the breast.

Understanding the BI-RADS Score on an Image Report

After undergoing breast imaging tests, your doctor will receive a report from the radiologist that includes a Breast Imaging Reporting and Data System (BI-RADS) score. This score ranges from 0 to 6, and it helps your gynecologist or primary care physician determine the best next steps.

  • A score of 0 indicates that there is not enough information to determine if cancer is present.
  • A score of 1 means there is no sign of cancer.
  • Scores of 2 or 3 indicate something was noticed, but it doesn't seem to be cancer. In these cases, the patient should be monitored over time.
  • Scores of 4 or 5 indicate the presence of a lump that could be cancerous, and a breast biopsy is recommended to make a determination.
  • A score of 6 means that the biopsy has confirmed the presence of cancer.

What to Expect After Diagnostic Imaging Tests Indicate Breast Cancer

If your diagnostic imaging tests indicate the possibility of breast cancer, the only way the doctor can verify the diagnosis is through a biopsy.

How a Breast Biopsy is Performed

During a breast biopsy, a small tissue sample is taken from the breast using a long needle. The surgeon numbs the area to help you feel more comfortable while the needle is inserted. Imaging scans are often used during the biopsy process to ensure the precise removal of tissue from the area of concern. This procedure usually takes 60 to 90 minutes and is outpatient. 


Breast Biopsy Pathology Report

After a biopsy, a pathologist examines the sample under a microscope to confirm whether cancer cells are present. If they are, the pathology doctor will also look for other cell characteristics to determine the exact type of breast cancer and how quickly it’s growing. They may also look for hormone receptors. The biopsy findings give the oncologist important information about treatments you may need.

What Happens When the Pathology Report Indicates Breast Cancer is Present?

If cancer is present, you will need to make an appointment with a breast cancer oncologist. You will also need to meet with a breast cancer surgeon. We suggest you start with the oncologist and discuss the order of treatments. They also regularly work with breast cancer surgeons in the area and can recommend one.

At your first oncology appointment, you will receive more information about your diagnosis. The oncologist will go over the results from your biopsy, imaging, and other tests required to create a treatment plan. Additional tests may still be needed to get a complete picture, but the oncologist can discuss what those are and why they’re needed. Take this opportunity to express your concerns, preferences, and hopes about treatment. 

Planning the Right Breast Cancer Treatment Plan for You

Breast cancer treatment is not the same for everyone because each case is unique. It must take into account different factors, including your age, overall health, specific type of breast cancer, tumor size, stage, hormone receptor status, and lymph node involvement.

Patients will typically receive one or several of the following:

  • Surgery. Surgery is usually the standard treatment to remove a breast tumor. You will discuss lumpectomy versus mastectomy and which is suitable for you with the breast cancer surgeon.
  • Radiation therapy. Radiation therapy uses high-energy beams to kill cancer cells. It is most often recommended after surgery to be sure all the cancer cells in the area are destroyed. In some cases, it may be used before surgery to shrink the tumor, requiring less breast tissue to be removed. Learn more about radiation for breast cancer. 
  • Hormone therapy. Hormone therapy is used to slow the growth of breast cancer that has hormone receptors by blocking the production of hormones like estrogen and progesterone that feed the cancer's growth. Not all breast cancer patients will use this treatment.
  • Chemotherapy. Chemotherapy uses drugs to destroy cancer cells. It becomes necessary when cancer cells start spreading to the lymph nodes. Chemo can effectively kill cancer cells by traveling through the bloodstream to reach them wherever they are located in the body.
  • Targeted therapy. Targeted therapy drugs attack specific proteins in cancer cells based on mutated genes. This type of treatment is used mainly in recurrent or metastatic breast cancer. 
  • Immunotherapy. Immunotherapy works by stimulating the body's immune system to attack cancer cells. It may be recommended for individuals with breast cancer that has returned locally or for those with triple-negative breast cancer. Immunotherapy can also be used as an alternative when surgery is not an option or when cancer has spread to other parts of the body.

Breast Cancer Specialists in the Albany Area

New York Oncology Hematology provides the most advanced breast cancer treatments in the Albany, New York area. One of our breast cancer specialists will carefully review your diagnosis, create a tailored treatment plan along with the other physicians on your team, and answer any questions you may have about the next steps.

Request an appointment at one of our locations throughout the Capital District, including Albany, Amsterdam, Hudson, Troy, and Clifton Park, New York. We provide leading-edge cancer treatments in your community.
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