Author: McLaren Flint
Mammograms are a standard screening radiology exam recommended for asymptomatic women over the age of 40 for early detection of breast cancer. Breast cancer is the most common cancer among women. Recommended yearly mammographic screening helps detect breast cancer early, which is easily amenable to less invasive treatment, decreasing mortality, morbidity, and significantly improving survival. So, what happens if you get a call back from your screening mammogram, and further testing is recommended? There are several reasons for screen callbacks.
“About 10 percent of women who receive a mammogram will receive a call back,” said Linda Lawrence, MD, board-certified radiologist, fellowship-trained breast radiologist, and medical director at the McLaren Flint Imaging Center. “This means that there is a finding that needs further imaging with either mammography, ultrasound, or both.”
In women who regularly have mammograms, comparisons are made with prior mammograms to evaluate for changes occurring in the breast over time, for example, new calcifications, masses, or developing asymmetries. If there are no prior mammograms, a baseline is first established.
“If this is a woman’s very first mammogram, there are no previous studies to compare to, so we need to establish a baseline exam to use for comparison for future reference,” said Dr. Lawrence. “Most of the time, a 6-month follow-up will be recommended to establish stability of what is being looked at. Occasionally, biopsy may be recommended.”
The breast’s density is the foremost parameter the radiologist evaluates. Not only does it affect the sensitivity of mammograms for the detection of breast cancer, but also women with dense breasts have an inherently increased risk of breast cancer.
A woman’s breast consists of three kinds of tissue including fibrous, glandular (the part of the breast that makes milk), and fatty tissues. When a woman’s breast has a greater percentage of fibrous and glandular tissue than fat tissue, it is known as dense breasts.
“Dense breast tissue means that masses are more difficult to detect due to the density of the breast tissue,” said Dr. Lawrence. Therefore, other modalities such as ultrasound or MRI may also be recommended.”
Digital breast tomosynthesis, also known as 3D mammography, provides multiple images of the breast in slices from various angles, much like flipping through the pages of a book instead of just looking at the whole book by its cover. This mammographic screening tool is particularly useful for women with dense breasts.
In addition to 3D mammography, McLaren Flint uses Volpara® Risk Pathways™, comprehensive breast cancer risk software, to help enable women to receive the right breast care based on their risk factors.
Women can assist in their risk assessment by providing details about personal and family health, which Volpara Risk Pathways evaluates through an easy-to-access digital health questionnaire.
Once a patient’s personal risk information has been collected, McLaren Flint Imaging Center can access a set of risk models and clinical guidelines to accurately identify and direct patients deemed to be at high risk for follow-up care, including genetic testing and medical imaging such as mammography, ultrasound, or breast MRI.
“The Volpara Risk Pathways has been a valuable addition for identifying people at increased risk for breast cancer who may require a higher level of surveillance and referral to our high-risk breast program,” said Dr. Lawrence.
Receiving a call back from a mammogram screening can be a stressful event, but the McLaren Flint Imaging staff will be there for patients every step of the way, providing the highest quality of care for diagnostic testing and screening. If it’s time for you to get a screening mammogram, you can schedule your appointment online at mclaren.org/flintfenton3dmamm.