Did You Get A Mammogram Callback? Don’t Panic — Here’s What Happens Next

You did it — you got your annual mammogram! Maybe this was your first baseline mammogram, or perhaps you’ve been through this routine many times before. You leave the department and await your news of an all-clear report. And then it happens: The phone rings. It’s the imaging facility calling to say you are a callback. Cue the heart-sinking, stomach-dropping panic.

My goal, as a nurse practitioner and medical writer specializing in breast health, is to help you navigate this moment without falling into a rabbit hole of fear fueled by endless Google searches. Instead, let’s take this one step at a time, knowing that statistically most callbacks do not end in a breast cancer diagnosis.

How often do abnormal mammograms or callbacks occur?

If 100 women have a mammogram, 90 will be told they have a normal mammogram, and 10 will be a callback. Of these 10:

• 6 will be told everything is normal after further imaging.
• 2 will need a 6-month follow-up.
• 2 will be recommended to have a breast biopsy.

Among those who undergo a biopsy, about 80% will be non-cancerous, or benign.

It’s All About the BI-RADS

Let’s break this down from the perspective of the doctor who reads your mammogram — the radiologist. They use a classification system called BI-RADS (Breast Imaging Reporting and Data System), which works like a rating scale to explain your results and what happens next. The scale ranges from 0 to 6. You can find this at the bottom of your mammogram report.

• BI-RADS 0: Incomplete. Additional evaluation and imaging are needed.
• BI-RADS 1: Negative.
• BI-RADS 2: Benign (non-cancerous) findings.
• BI-RADS 3: “Probably benign” findings.
• BI-RADS 4: Suspicious for cancer (this also has three subtypes: A, B, and C for low, moderate, and high suspicion). Overall, there is about a 2 to 95% chance of malignancy (cancer)
• BI-RADS 5: Highly suspicious for malignancy (>95%).
• BI-RADS 6: There is a known biopsy-proven malignancy.

If you get called back after a mammogram, your report will show BI-RADS 0. This means the radiologist needs more information before giving a final result. Sometimes, it’s as simple as needing your previous scans from another facility for comparison. Other times, they’ve spotted an area that needs a closer look.

After you complete your callback imaging — typically extra mammogram views and sometimes an ultrasound — the radiologist will review the results and determine the next steps. In most cases (about 60% of the time), the area of concern turns out to be considered benign, like normal breast tissue or a simple cyst. If that happens, you’ll get the all-clear (BI-RADS 1 or 2).

In some cases, the callback imaging wasn’t helpful enough and the radiologist may recommend a breast MRI for further evaluation.

Probably Benign: The 6-Month Follow-Up

If you’re one of the many women told your imaging findings are “probably benign” (BI-RADS 3) and need a follow-up in six months, you’re not alone. And let’s be real — no one loves the word probably.

But here’s the deal: BI-RADS 3 is a less than 2% chance of malignancy. Not everything needs a biopsy. If so, it would cause unnecessary stress, anxiety, extra costs, and some discomfort (although this is usually very minimal). Instead, radiologists carefully examine the image and decide how suspicious it looks. This is what guides the next steps — whether to monitor or biopsy.

The American College of Radiology and studies on breast cancer surveillance found that six months is an optimal time frame to detect changes while minimizing anxiety and unnecessary procedures. The area is followed for two years and then is considered stable.

“Probably Benign” Findings Explained

Common breast findings that may warrant six-months follow-up:

• Fibroadenoma: The most common benign mass. Solid, mobile, well-defined.
• Complicated Cyst: Unlike simple cysts, which are fluid-filled, these cysts have debris inside, giving a more solid appearance
• Calcifications: Tiny calcium deposits in the breasts.
• Asymmetry: When an area in one breast looks different compared to the same area in the other breast.
• Architectural Distortion: When the normal structure of the breast tissue looks pulled or twisted
• Fat Necrosis: Occurs when fatty tissue is damaged, usually after injury or surgery.

I don’t want to wait. Now what?

Maybe you have a family history of breast cancer, or maybe the uncertainty of it all is weighing too heavily. If waiting is keeping you up at night or stealing your peace, it’s time to biopsy. Keep in mind that sometimes — even after a biopsy — a six-month follow-up may still be recommended based on the radiologist’s discretion.

In most cases, a biopsy can be done, but sometimes, the radiologist might feel it’s too risky to safely biopsy based on the location and other factors. If that happens, you may be referred to a surgeon.

A Few Tips

✔️ To help avoid a callback, make sure the facility doing your imaging has your previous breast scans. This might mean requesting a disc of your past imaging from your previous facility’s radiology department and bringing it to your appointment.

✔️ Stay within the same healthcare facility, or their satellite locations, every year for consistency.

✔️ Ask to speak with the radiologist if you have questions. Most breast centers will let you talk to the expert who is reading your imaging. They can walk you through what they’re seeing, why follow-up is recommended, and what other options you might have.

✔️ Still feeling unsure? Get a second opinion. Consider asking for a referral to a breast surgeon. These specialists and their teams can review your breast imaging, help assess your overall risk, explore other imaging options (like a breast MRI), and guide you through the decision-making process. Plus, if you’re found to be at high risk for breast cancer, they’ll often follow you for years, keeping an extra-close eye on you.

Bottom line? You do have options. Callbacks will happen, and now you will feel more prepared.