What Happens After an Abnormal Mammogram?
By Amanda Loeffler, M.D.
Breast Surgeon
Stormont Vail Health
For many women, it starts with a phone call after a routine mammogram. Something looks abnormal, and additional imaging is recommended. Sometimes a biopsy is needed.
Almost immediately, the same question comes up:
“What happens next?”
As a breast surgeon, I meet patients every day who are navigating that uncertainty. The good news is that an abnormal mammogram does not automatically mean cancer. In fact, most abnormal findings turn out to be benign. Still, the days and weeks that follow can feel overwhelming if you don’t know what to expect.
Understanding the process can help reduce anxiety and ensure you’re prepared to make informed decisions about your care.
STEP ONE: ADDITIONAL IMAGING
If something unusual appears on a screening mammogram, the first step is often additional imaging.
This may include diagnostic mammography, ultrasound or, in some cases, breast MRI. These tests allow radiologists to take a closer look at the area of concern and determine whether additional evaluation is necessary.
Many patients are surprised to learn how common this is. Being called back for additional imaging is fairly routine, and most women who receive a callback do not ultimately receive a cancer diagnosis.
Depending on scheduling availability and the urgency of the finding, additional imaging often occurs within days to a few weeks.
STEP TWO: THE BIOPSY
If imaging still raises concern, a biopsy may be recommended.
A biopsy involves removing a small tissue sample so it can be examined under a microscope. Modern breast biopsies are minimally invasive and are typically performed using imaging guidance with local anesthesia. Most patients return to normal activities quickly afterward.
STEP THREE: UNDERSTANDING THE RESULTS
Waiting for biopsy results is often the most stressful part of the process. While timelines vary, pathology results are frequently available within several business days.
When those results arrive, patients generally fall into one of three categories:
Benign findings that require little or no additional treatment
High-risk findings that may need surgery or closer monitoring
A diagnosis of breast cancer that requires treatment planning
Each path is different, which is why individualized recommendations are so important.
WHAT DOES A BREAST SURGEON ACTUALLY DO?
Many people assume breast surgeons only become involved if an operation is needed. In reality, a breast surgeon often serves as a guide long before surgery enters the conversation.
We help patients understand biopsy results, explain treatment options, coordinate additional testing, review family history and risk factors, and answer questions about what comes next. In many cases, our role is helping patients navigate complex information at a time when they may feel overwhelmed.
For patients diagnosed with breast cancer, treatment planning may involve conversations about surgery, but it also often includes coordination with oncology, plastic surgery, counseling, radiology and nursing teams.
Breast cancer treatment today is highly personalized. Two patients with seemingly similar diagnoses may receive very different recommendations based on tumor biology, age, overall health, genetic factors and personal preferences.
QUESTIONS EVERY PATIENT SHOULD ASK
Whether you’re seeking care locally or at a major medical center, there are several important questions worth asking your breast care team:
1. Who will help coordinate my care?
Breast cancer care can involve many specialists and appointments. A nurse navigator helps connect the pieces, coordinating your care, answering questions and helping you understand what comes next.
2. How quickly can I expect results and next steps?
Knowing realistic timelines helps reduce uncertainty and ensures important decisions are not delayed.
3. Will my case be reviewed by multiple specialists?
Many breast programs use multidisciplinary meetings where experts from different specialties review cases together and discuss treatment recommendations.
4. What support resources are available?
Patients often benefit from nurse navigators, support groups, counseling services, nutrition support and financial guidance during treatment.
5. What are all of my treatment options?
The best decisions are made when patients fully understand the benefits, risks and alternatives associated with each option.
WHEN SHOULD YOU CONSIDER A SECOND OPINION?
Many patients worry that seeking a second opinion might offend their physician. It shouldn’t.
A second opinion is completely appropriate after a new breast cancer diagnosis, when treatment options are complex, when reconstruction decisions are involved or simply when a patient wants additional reassurance before moving forward.
Most physicians welcome second opinions because the goal is the same for everyone involved: helping patients feel confident in their treatment plan.
In many cases, a second opinion confirms the original recommendation. Even then, it can provide peace of mind during a difficult time.
THE VALUE OF COORDINATED CARE
One lesson I’ve learned throughout my career is that patients don’t just need treatment. They need clarity.
The most successful breast care programs help patients move efficiently from screening and diagnosis to treatment and recovery while ensuring communication remains consistent along the way. When specialists work together and information flows smoothly between providers, patients can spend less time navigating the health care system and more time focusing on their health.
Most importantly, patients should never feel alone in the process.
An abnormal mammogram can be frightening, but understanding the steps ahead can make the experience more manageable. Ask questions. Take notes. Bring a trusted friend or family member to appointments. And don’t be afraid to seek additional information if you need it.
The path forward may not always be easy, but with the right information and support, it becomes much easier to navigate.
