June 9, 2016

Here’s what you should know if you are put on ‘breast imaging surveillance’ after a mammogram.


So, you were bouncing along in mammographic screening bliss, anticipating the coveted “no evidence of cancer” post screening letter in the mail, and then…. BOOM, something your radiologist found on the image results in a mammogram call back, landing you in “breast imaging surveillance.”

Your initial reaction: panic, perhaps. My advice: Take a deep breath.

Before making it to the ledge you should know, there’s a lot of mammogram call back reasons. Let’s explore what breast imaging surveillance really means.

What is “breast imaging surveillance?”

Breast imaging may be done for a variety of reasons. Screening imaging – typically a mammogram – is performed on women who have no symptoms based on research that shows it can make a difference in catching early cancers and reducing death from cancers. Diagnostic imaging is done when there is a specific symptom or clinical concern – a lump, for example.

Think of the “breast imaging surveillance” the same way as you would the patrol of a security guard at a mall, on alert and watching for an event that is unlikely to occur. It means that the radiologist has seen something on the image that merits more focused assessment.

If you are placed in surveillance, the radiologist interpreting your breast imaging study estimates your risk of cancer to be less than 2 percent – in other words, 98 percent likely to not be cancer.

Mammogram Call Back Reasons

Breast imaging surveillance is usually initiated for two main reasons:

1. The most common reason is to watch closely an area seen on mammogram, breast ultrasound or breast MRI.

2. To follow breast biopsy sites, confirming over time that there is no unexpected change.

Typically, follow-up breast imaging is done at 6 months, 12 months and 24 months after observance of the imaging finding in question, or following a breast biopsy with benign pathology results. Your radiologist may recommend follow-up mammograms only, ultrasounds only, MRIs only or some combination.

No matter what way the finding is reassessed, the goal is to achieve a more targeted look at the area in question. The finding is evaluated to make sure there has been no worrisome change – or if there is, to take quick action to protect your health.

The results of each assessment are discussed with you during your scheduled visit. You should take the opportunity to ask any and all questions you may have and to share any concerns.

After two years, if there have been no concerning changes, the surveillance period usually ends. You’ll likely go back to a routine screening schedule, depending on age and any specific risk factors for breast cancer that you may have.

So if you do get the letter or phone call that says you need to come back for more imaging, take a breath. Your breast center’s got you.

This post was written by Andrea Birch, M.D., who specializes in radiology at the Vanderbilt Breast Center at One Hundred Oaks in Nashville.

The Vanderbilt Breast Center provides the most complete range of services for breast health in Middle Tennessee. The center, located at One Hundred Oaks, offers screening, imaging, genetic testing and breast cancer care. To make an appointment, call 615-322-2064.