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About 5% of women having a screening mammogram will have an abnormal result, finding microcalcifications, masses, or areas of distortion. Microcalcifications are tiny deposits of calcium that appear as white dots on the mammogram. Most microcalcifications are easily recognized as being associated with benign processes in breast tissue such as fibrocystic changes; others however are not easily classified and may be found in early breast cancer especially if tightly clustered. Masses may be due to cysts, benign tumors such as fibroadenomas or breast cancers. Areas of distortion may be seen with scar tissue but occasionally may be a very subtle sign of a breast cancer.

Many of these abnormalities will simply require additional special mammogram views, an ultrasound or MRI to resolve any concerns; for other women a recommendation for short term follow up or a biopsy may be made. Short term follow up is suggested when the mammogram show a finding that is almost certainly benign, but the radiologist who reads the mammogram feels a short term follow up study would help confirm that impression. Almost all such follow up studies are reassuring and no special additional evaluation is needed. Occasionally there will be a change and in about 2% of these patients a biopsy recommendation may be made. Most often, short term follow up is performed at a six month interval; this is felt to be a reasonable time frame in which if a change does occur, it can be recognized and appropriate action be taken.

Surgical consultation or a biopsy may be recommended for certain findings on a mammogram. Although a mammogram may be assessed as "suspicious", most such patients (about 80-85%) have a biopsy showing no evidence of cancer; this is because the earliest signs of breast cancer may be subtle and very similar to benign processes on the mammogram. Less commonly, a mammogram may be interpreted as "highly suggestive of malignancy". Such findings reflect near certain presence of a breast cancer.

		Abnormal mammogram showing a very tiny cancer (0.5cm) CC (top down) view. Click on the image for a larger view.
		Abnormal mammogram showing a very tiny cancer on the MLO (sideways) view. Click on the image for a larger view.
		Abnormal mammogram showing malignant calcifications. Click on the image for a larger view.

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