What does it mean if you have an abnormal mammogram?

Women's Health

by Patricia Krakos, MD

Jun 5, 2024

Mammograms are an essential part of a woman's wellness routine. This imaging test looks for any lumps, masses or abnormalities in the breast, which could be signs of breast cancer.

While many women will have an annual mammogram and receive normal results, there may be an occasion where a test comes back as "abnormal"

So, what does this mean? Let’s take a closer look at what an abnormal mammogram is and what you can expect after getting your results.

What is a mammogram?

A mammogram is a low-dose X-ray that looks for signs of breast cancer before you have any breast cancer symptoms. It’s recommended that women have their first mammogram at the age of 40 and continue these screenings each year.

There are two types of mammograms:

  • Screening mammogram: This is a routine type of mammogram for women who have no symptoms of breast cancer and for those who have an average risk of developing breast problems.
  • Diagnostic mammogram: This type of mammogram is for those who have symptoms of breast cancer or who have received abnormal results from a screening mammogram.

The symptoms of breast cancer include:

  • A lump in your breast or near your breast, such as your underarm
  • Bloody or clear drainage from your nipple
  • Changes in skin texture, such as redness, dimpling, scaling or an orange peel-like texture
  • Thickening or swelling of the breast
  • Changes in the nipple or hardening of the nipple

If you’re experiencing any of these symptoms, it’s important to speak with your doctor.

What does it mean if you have an abnormal mammogram?

An abnormal screening mammogram result is when someone has no symptoms of breast cancer, but the results come back with signs that require further testing.

If you have a screening mammogram that comes back as abnormal, you will be contacted to return for a diagnostic mammogram and possibly an ultrasound to determine if there are any findings that are suspicious for breast cancer.

If the examination is your first mammogram, or if there are no previous mammograms that can be compared to, you may need to come back to determine if the findings are normal for you. Breast tissue has variations in appearance, and it is very important that your mammogram is compared with your previous mammograms if they are available.

What are the types of abnormal mammograms?

Multiple abnormalities can be detected on a mammogram:

  • Masses, which can be round or irregular
  • Calcifications, which are mineral deposits in abnormal tissue areas. These can be benign (non-cancerous) or due to cancer
  • Areas of dense breast tissue, which are asymmetric between the two breasts
  • Abnormalities of the nipple or skin
  • Abnormal lymph nodes

About 10% of screening mammograms are read as “inconclusive” or possibly having an abnormality. By far and away, these are not due to breast cancer, but other benign things such as cysts or asymmetric breast tissue.

Only about 5% of people who are called back because of an abnormal mammogram will actually have breast cancer.

How does dense breast tissue cause abnormal mammograms?

Dense breast tissue can make it difficult to see an underlying cancer. Women with dense breast tissue have a greater chance of being called back for additional imaging to make sure nothing is hiding within this dense breast tissue.

How often do false-positive results mammogram results happen?

False-positive mammograms occur about 10% of the time. These are mammograms that show an abnormality that is not cancer. False positives are typically due to dense breast tissue and not having any previous mammograms for comparison.

What tests are available after an abnormal mammogram?

If your mammogram comes back as abnormal, your provider will reach out to you with next steps. Further diagnostic tests recommended after an abnormal mammogram can include:

Your healthcare team understands that it can be scary to hear you have abnormal results. The important thing to remember is that most abnormal mammogram results are not due to breast cancer.

If you have questions about your breast health, get started by finding a provider near you or scheduling a mammogram.

About the Author

Patricia Krakos, MD, is a diagnostic radiologist at Baylor Scott & White Medical Center – Plano.

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