You have a mammogram as you normally would. A few days later, you receive a call or a letter from the doctor asking you to come back for more tests. It is normal to feel very scared and anxious when you hear something like this. Your mind starts to think about all sorts of things. But I say, don't worry . Being asked to come back for tests like this is not as bad as you think. Let's be clear about this.
In fact, it's very common to be asked to come back this way. And it doesn't necessarily mean you have cancer. According to statistics, less than one in ten women who are called back for tests this way are ultimately confirmed to have breast cancer. But, you can't just ignore it. You should definitely look into it. So, these tips will help you prepare yourself before your next test and make the whole process easier.
What will happen on your next test day?
When you come back, you will probably have a "Diagnostic Mammogram" and an ultrasound scan. This diagnostic mammogram may take a little longer than your regular mammogram because the technician will take more X-ray images of your breast. For example, they may need to magnify any suspicious areas, or they may need to take more images if the previous images were not clear enough.
As before, you will be stripped from the waist up and will stand in front of the mammogram machine. The technician will place your breast between two plates and press them together. This is done for a few seconds to spread the breast tissue out and get a clear X-ray image. This is repeated several times until all the images you need are taken.
Can the discomfort of the test be reduced?
Some people find the pressure of a mammogram uncomfortable. If that's the case for you, you can talk to your doctor about taking an over-the-counter pain medicine about an hour before the test. If you're not yet menopausal, try to schedule your mammogram after your period, when your breasts are less tender and sensitive.
An ultrasound involves you lying face down on an exam table. The technician then applies a clear gel to the surface of your breast and moves a device called a transducer over your skin. This emits high-frequency sound waves that bounce off the tissues inside and capture the echoes that bounce back. A computer converts these echoes into images of what's inside your breast.There is no pain during the ultrasound examination. However, the gel applied to the skin may feel a little cold. It is often used to check for something suspicious that appeared on a mammogram or a lump that the doctor can feel but is not visible on the mammogram.
Sometimes, if your doctor thinks that a mammogram and ultrasound alone are not enough to accurately diagnose a suspicious area, they may also recommend an MRI scan. This uses magnets and radio waves to produce very clear, detailed images of the inside of the breast.
When talking to the doctor...
In most cases, the doctor (radiologist) who reviews your scan report can tell you the results right away. It is very important to give your old mammogram reports to this doctor as well . It is very important to compare the old reports with the new reports.
Think about it, something like a lump that has been the same shape for years without any change is most likely not cancerous. That's why old records are essential.
After reviewing your test results, your doctor may make one of the following decisions:
- No problem, come back in a year as usual: This means that what caused the suspicion is not dangerous, and you can come back for the test as usual in a year.
- Check back in 6 months: If you see a change on your mammogram or ultrasound, it's likely benign. However, you should get checked again in about 6 months to see if it changes over time.
- A biopsy may be needed: A biopsy may be recommended to determine whether a suspicious area in the breast is cancerous. For example, a biopsy is often needed for microcalcifications - tiny calcium deposits - and lumps (not cysts) that are present in a certain pattern.
If a biopsy is needed...
If a biopsy is needed, it will usually be scheduled for another day within the next week. Most breast biopsies are done as outpatient procedures, meaning you don't have to stay in the hospital. A biopsy involves taking a small piece of tissue or fluid from your breast and examining it under a microscope. Depending on the size, location, and other factors of the suspicious area, your doctor will choose one of the following types of biopsy.
| Biopsy Type | Procedure and What to Expect |
|---|---|
| Fine Needle Aspiration (FNA) Biopsy | A very thin, hollow needle is used to remove a small amount of tissue or fluid from the suspicious area. You may be given a numbing medication, which may or may not be necessary. The needle is guided to the correct location using ultrasound. There may be some bruising afterwards, but no stitches are needed. |
| Core Needle Biopsy | A small, hollow needle is used to take several tissue samples. The area is numbed before this is done. You will feel a slight burning sensation when the numbing medicine is injected. A scanning method, such as ultrasound, is also used here. There may be a small scar and bruising afterwards, but no stitches are needed. |
| Surgical Biopsy | A surgeon will make an incision and remove all or part of the suspicious tissue. This is done under general anesthesia or by giving you a sedative to numb the area. (So, have someone take you home with you.) The skin will be closed with stitches, leaving a small scar. You may feel some pain for a few days, and your doctor will prescribe painkillers. |
After the biopsy, the tissue sample is sent to a lab. There, a pathologist examines it under a microscope to determine whether or not cancer cells are present. It usually takes about a week for the biopsy report to come back. Your doctor will then talk to you about it.
How do you calm down during this time?
Many women feel a lot of stress and anxiety while undergoing tests and waiting for the results. It's very normal.
Doctors say that the best way to stay calm during this time is to be well-informed about the tests you are having. Write down your questions in a notebook and ask the doctor. This will give you a sense of control. Another important thing is to take a trusted friend or family member with you to these tests . It is a big help to have a second person listening to what the doctor is saying. That person can write down the facts for you and give you emotional support.
Take-Home Message
- It's very common to be asked to come back for follow-up tests after a mammogram. It doesn't necessarily mean you have cancer.
- Diagnostic Mammogram and Ultrasound Scan are common, standard tests performed at times like this.
- When you go for your check-ups, be sure to bring your old mammogram records . It's very important to compare them.
- If a biopsy is needed, there are different methods for doing so. Your doctor will choose the method that is best for you. Most of these are simple procedures.
- Never be afraid to ask your doctor questions. It's a good idea to bring a friend or family member for support.
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