Understanding Your Mammogram Results: What Dr. Heidi Hartman, Radiologist, Wants You To Know
Receiving mammogram results can feel overwhelming, but understanding what they mean can help ease concerns. Dr. Heidi Hartman, board certified radiologist with CaroMont Health’s breast imaging program, wants to help you understand everything you need to know about your mammogram results. Whether you’ve just had your first screening, or you’ve been notified of a recent change, here's what an expert in the field of breast health wants you to understand:
The BI-RADS System and How It Informs Your Care
BI-RADS or Breast Imaging Reporting and Data System is a tool used by radiologists to report breast imaging findings and communicate clear follow-up recommendations.
"In our practice as radiologists, using BI-RADS helps standardize mammogram reporting. I can describe what I’m seeing and assign any abnormalities a category that helps us recommend the appropriate follow-up care for each patient. While an abnormal mammogram can feel concerning, understanding what the BI-RADS categories mean helps patients be in better control of their breast health.”
Dr. Hartman describes each BI-RADS category as follows:
Category 0: Incomplete
This categorization means additional imaging is needed. This result is common and does not mean something is wrong, as there are a variety of reasons a radiologist would request additional images and/or ultrasound.
Category 1: Negative
This means the imaging showed no evidence of cancer. I would recommend the patient continue routine screening.
Category 2: Benign Finding
This category also means there is no evidence of cancer, but other benign findings are present. Some examples of benign findings include surgical changes or cysts. For this patient, routine screening is also recommended.
Category 3: Probably Benign
This category indicates a finding that we believe to be benign and with a very low likelihood of cancer (less than 2%). As a measure of precaution, follow-up imaging is recommended, usually in 6 months.
Category 4: Suspicious
This result means I have identified something that appears abnormal, but not necessarily cancer. For this result, a biopsy would be recommended to make a diagnosis, but be aware that the majority of Category 4 findings are ultimately found to be non-cancerous.
Category 5: Highly Suggestive of Malignancy
The findings in this category have a high likelihood of malignant cancer, and biopsy is strongly recommended.
Category 6: Known Cancer
This category is used for findings that have been proven by biopsy to be cancer. We use this categorization after diagnosis, usually to see how a tumor is responding to treatment.
Breast Density Results
Approximately 40% of women in the United States over the age of 40 have dense breasts. Many will not even know they have dense breasts until after their mammograms are completed.
“It's important to know if your breast tissue is dense and to understand that dense tissue can obscure tumors on a mammogram, making them harder to detect,” Dr. Hartman explains. “Women with dense breasts also have a slightly higher risk of breast cancer and may benefit from supplemental screening, such as ultrasound or MRI. Automated Breast Ultrasound is available for our patients and can be performed in addition to your yearly mammogram if you have dense breasts. It’s important to remember that all women complete annual screening mammograms regardless of density.”
After an Abnormal Result
The American Cancer Society notes that fewer than one in 10 women called back for additional imaging after a mammogram have cancer. There are a variety of reasons more imaging is needed including overlapping tissue, injury to the area, prior surgery or no prior images for comparison. Follow-up may include diagnostic mammograms, ultrasound or biopsy.
"If you're called back for additional imaging, that is not a reason to panic,” Dr. Hartman reassures. “Many callbacks are simply because we need a clearer picture or a different angle. Often, it's nothing to worry about. What matters most is that you showed up for your screening in the first place and that you follow through with any additional steps. That's how early detection works, and it can truly save lives."
Key Takeaways
As Dr. Hartman states, the most important thing a person can do is be proactive through regularly scheduled mammograms, performing monthly self-exams and reporting changes to your primary care provider. Every woman should receive a screening mammogram annually beginning at age 40.
Act Today
Don't wait to prioritize your breast health. Talk to your primary care provider about when you should begin screening based on your age, family history and risk factors. If you’re due for an annual mammogram, CaroMont Health offers convenient online scheduling in MyChart.
Mark your calendar for annual screenings and share this information with your loved ones. Early detection truly saves lives, and understanding your mammogram results is the first step toward taking control of your breast health.