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Called Back After an Abnormal Mammogram? What Happens Next
Reviewed by Elizabeth Arena, MD, FACS. Last reviewed: October 25, 2026.
Being asked to come back after a screening mammogram usually means the radiologist wants more images of one area of your breast. Fewer than 1 in 10 women who are called back turn out to have cancer. [1]
What does an abnormal mammogram mean?
An abnormal screening mammogram means the radiologist, the doctor who reads your images, saw an area that needs more images before your result can be called normal. The radiologist uses those extra images to decide whether the area is normal, benign or needs a biopsy. [1]
You may be called back because of:
- An unclear image: some breast tissue was missed or blurred, so the view has to be taken again.
- A mass: a lump that could be a fluid-filled cyst or a solid growth.
- Calcifications: tiny calcium deposits that the radiologist wants to see more closely.
- An asymmetry: one part of your breast looks different from the rest.
- A change from last time: something on this mammogram was not on your earlier ones.
Callbacks are more common after a first mammogram, before menopause and in women with dense breasts. [1] When the radiologist can compare your new images with earlier mammograms, the chance of a false positive, an abnormal result that turns out not to be cancer, is about half as high. [2]
What does an abnormal mammogram look like?
Dense breast tissue, masses and calcifications all show up white on a mammogram. The radiologist looks at a mass's size, shape and edges. A mass that looks smooth and round with sharp edges is usually benign and is often a cyst. [4]
| Finding on your report | How it looks on the mammogram | What it usually means |
|---|---|---|
| Round or oval mass with clear edges (circumscribed) | A smooth white shape with a sharp outline | Often a cyst; ultrasound can confirm it [4] |
| Irregular mass (spiculated, if the edges are spiky) | A white shape with a jagged outline | More concerning; needs more tests [4] |
| Macrocalcifications | Larger white dots | Changes from aging, an old injury or inflammation; usually benign [4] |
| Microcalcifications | Tiny white specks | Depends on the pattern: grouped in certain ways, they can be a sign of breast cancer or of ductal carcinoma in situ (DCIS), abnormal cells that have not spread beyond a milk duct [4] |
| Asymmetry | One area that looks different from the rest of your breast | Often no longer looks suspicious once it is compressed or X-rayed again [1] |
What happens at your follow-up appointment?
The follow-up appointment is usually a diagnostic mammogram at an imaging center, often with an ultrasound on the same day. The new images cover only the area flagged on your screening mammogram. A radiologist checks the images while you are there and decides which views are needed. [1]
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Breast ultrasound
Sound waves show whether a lump is solid or filled with fluid. [4]
-
Breast MRI, occasionally
An MRI is one of the extra tests a radiologist can recommend after an abnormal mammogram. [2]
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Your result
You will most likely hear it before you leave. [1] It is one of three: the area is normal or benign and you go back to routine screening; it is probably benign and needs another scan, usually in about six months; or it could be cancer and needs a biopsy. A letter with the result follows. [1]
What does your BI-RADS category mean?
The radiologist gives your result a category in BI-RADS, the Breast Imaging Reporting and Data System, which is the standard way radiologists report mammogram, ultrasound and MRI results. A screening callback is reported as category 0, incomplete. [3] [5]
| Category | Assessment | Chance of cancer [3] | Usual next step |
|---|---|---|---|
| 0 | Incomplete | Not yet known | More imaging or comparison with earlier mammograms |
| 1 | Negative | No sign of cancer | Routine screening |
| 2 | Benign finding | No sign of cancer | Routine screening |
| 3 | Probably benign | No more than 2% | Repeat imaging in 6 to 12 months, then regularly for at least 2 years |
| 4A, 4B, 4C | Suspicious | More than 2% and less than 95% | Biopsy |
| 5 | Highly suggestive of cancer | At least 95% | Biopsy |
| 6 | Cancer already shown by biopsy | Known | Treatment planning |
How long does each step take?
A study of the American College of Radiology's National Mammography Database looked at 2.87 million abnormal screening mammograms at U.S. facilities from 2008 to 2021. The median time from the screening mammogram to the diagnostic visit was 9 days, meaning half of women waited 9 days or less.
For women who then needed a biopsy, the median time from the diagnostic visit to the biopsy was another 21 days. Waits varied widely between facilities and between groups of women. [5] To shorten your own wait:
- Booking: ask the imaging center for its first opening and whether the ultrasound can be done at the same visit as the diagnostic mammogram.
- Getting your result: ask when it will be ready, whether it comes by phone, letter or patient portal and whom to call if it does not arrive.
- A lump you can feel: a lump needs an exam whatever the mammogram shows; see what to do after finding a breast lump.
When should you see a breast surgeon after an abnormal mammogram?
A visit with a breast surgeon does not replace your diagnostic mammogram, so keep that appointment. You need a breast surgeon if a biopsy finds cancer or atypical cells, which are abnormal cells that are not cancer, or if a lump has to be removed. You can also see one before a biopsy. Reasons women do:
- A lump you can feel: in the same area or anywhere else in your breast.
- A BI-RADS 3 result: an exam and an ultrasound before the follow-up scan.
- A recommended biopsy: questions about why it is needed and which kind it will be.
- Mismatched results: the mammogram shows an area that the ultrasound does not, or the reverse.
- A high risk of breast cancer: from family history or a gene mutation; see high-risk screening.
Dr. Arena sees women for an evaluation after an abnormal mammogram. She can examine the area and use in-office ultrasound when clinically appropriate.
What happens if you need a biopsy?
In a biopsy, a doctor removes a small piece of tissue so a pathologist can look for cancer cells under a microscope. Only a biopsy can show whether a finding is cancer; most biopsies show no cancer. [1]
- Core needle biopsy: after numbing your skin, the doctor uses a hollow needle, guided by ultrasound, mammogram or MRI, to take several thin cores of tissue. A tiny marker clip is usually left in the spot so later scans can find it. You go home the same day and can usually return to your normal activities after a day or so. [6]
- Excisional (surgical) biopsy: a surgeon removes the whole area through an incision, a cut in your skin. [1] When a needle biopsy result is unclear or the doctor is still concerned, the next test may be a second needle biopsy or an excisional biopsy. [6] Dr. Arena performs excisional biopsies.
What if the biopsy finds cancer?
If your biopsy shows breast cancer, Dr. Arena goes through the pathology report with you, orders any imaging she needs to measure the tumor and explains which operations fit the cancer you have, so you can choose between lumpectomy and mastectomy. When a medical oncologist, a doctor who treats cancer with medication, recommends drug treatment before surgery, Dr. Arena schedules your operation for after it.
Frequently asked questions
How often is an abnormal mammogram actually cancer?
Should I be worried if I need an ultrasound after a mammogram?
How long does it take to get diagnostic mammogram results?
Can I see a breast surgeon before I have a biopsy?
Yes. You can request an appointment with Dr. Arena before a biopsy; keep your diagnostic mammogram appointment as well.
Sources
- American Cancer Society. Getting Called Back After a Mammogram. Last revised July 23, 2026. https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/mammograms/getting-called-back-after-a-mammogram.html
- American Cancer Society. Limitations of Mammograms. https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/mammograms/limitations-of-mammograms.html
- American Cancer Society. Understanding Your Mammogram Report. Last revised July 23, 2026. https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/mammograms/understanding-your-mammogram-report.html
- National Cancer Institute. Understanding Breast Changes and Conditions: A Health Guide. NIH Publication No. 24-3536, August 2024. https://www.cancer.gov/types/breast/breast-changes/understanding-breast-changes.pdf
- Oluyemi ET, Grimm LJ, Goldman L, et al. Rate and Timeliness of Diagnostic Evaluation and Biopsy After Recall From Screening Mammography in the National Mammography Database. Journal of the American College of Radiology. 2024. doi:10.1016/j.jacr.2023.09.002
- American Cancer Society. Core Needle Biopsy of the Breast. https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/breast-biopsy/core-needle-biopsy-of-the-breast.html
Speak with Dr Arena about your next step
Whether you have a new diagnosis, want another opinion, are weighing surgical options or need a concerning finding assessed, the first step is a consultation focused on your specific situation.