Taking the Scare Out of an Abnormal Mammogram

When I talk to women about what prevents them from getting their screening mammograms, some cite busy schedules or just plain forgetfulness. Surprisingly, many say that they would just rather not know. They have seen a friend or acquaintance struggle with—or even succumb to—breast cancer, and their fear is just too much to bear.

While I understand the anxiety, it so important to remember that screening mammograms are the best way to catch breast cancer early. Cancer caught earlier is easier to cure. And modern treatments for those who are diagnosed with early stage breast cancer cause far less disruption to your daily life than the treatments of the past.

Knowing what to expect and learning the odds of a diagnosis may make the emotional stress of getting a mammogram, or coming back in for recommended diagnostic mammograms and breast ultrasounds, easier to manage. Hopefully, this brief overview will help you think of your mammogram in the same way you think of getting your teeth cleaned. It’s a preventive procedure that increases the chances for a long and happy life.

Here are some stats, which are listed on and verified by the educational website mammographysaveslives.org, a great resource of patient information about mammography and breast cancer. For every 1,000 women who have a screening mammogram, 900 are clear and show no signs of an area that could be suspicious for cancer. You are fantastically likely to be among the 900. The remaining 100 women get a call from a friendly and helpful staff member who shares that the radiologist has recommended she return to the imaging center for a “diagnostic” mammogram and/or an ultrasound and helps her schedule and appointment to come back in.

Radiologists, the doctors who specialize in imaging, recommend diagnostic mammograms and/or breast ultrasounds when they need more information about your breast tissue. While screening mammograms provide the radiologist with whole breast “pictures” of your breast, diagnostic imaging is directed to a specific area of question. We call these “pictures” spot magnification views. They literally magnify a specific area for the radiologists to review and compare to any prior breast imaging we have for you. From among those 100 women, just 20 will learn that they have a suspicious area that has been recommended for biopsy. (This can be a little frightening, no doubt. But hang in there. Even after all of these tests, there is still a 75 percent chance that these biopsies will show benign or non-cancerous results.) If you are having your imaging done at SVMC, you will meet a breast health navigator. She will help you understand what is going on and help you with your next step.

These 20 women will be referred for a needle biopsy. This means that a radiologist, imaging technologists and a imaging registered nurse will use mammography or ultrasound to guide them to the exact location of the area of concern in your breast. After you’ve been numbed for comfort, a hollow needle is inserted into the area of concern. Small tissue samples are removed through that hollow needle and sent to be tested by a pathologist to see whether or not cancer cells are present.

Just five of the original 1,000 women—that’s one half of one percent—will be diagnosed with breast cancer. If they have had regular mammograms it is more than likely that the cancer will be caught in its earliest stages.

If the diagnosis rates are so low, why don’t I just play the odds, you ask? We all know how time flies. It doesn’t take long for a very treatable cancer to get out of hand. If you have questions about screening and diagnostic breast mammograms and ultrasounds and why they are important to your health and wellness, I invite you to call me at 802 440-4244.

Please note that while screening mammograms, typically, are not subject to your insurance deductible therefore you most likely have no out of pocket expense, diagnostic mammograms and ultrasounds are usually applied toward your insurance deductible. If you have not met your deductible you may have an out of pocket expense. At SVMC, we encourage women to ask for an estimate. If the cost is more than you can afford, we can help you apply for funds from Ladies First of Vermont or the grant we received from Susan G. Komen Foundation, for instance, to cover the test or help you with a payment plan.

Rebecca Hewson-Steller, RN, CN-BN, is the breast health navigator at SVMC Women’s Imaging and the Southwestern Vermont Regional Cancer Center. “Health Matters” is a column meant to educate readers about their personal health, public health matters, and public policy as it affects health care. For this article and others like it, visit svhealthcare.org/wellnessconnection.