An “incomplete mammogram” can be a source of worry, yet it is a common occurrence in breast cancer screening. This designation simply indicates that the initial images did not provide enough information for a definitive assessment, necessitating further investigation. It is a routine part of the screening process for many individuals and does not automatically imply a serious problem.
Understanding the “Incomplete” Designation
An incomplete mammogram, often categorized as BI-RADS 0, means that the radiologist requires additional imaging or comparison with previous mammograms to complete the assessment. This classification is a temporary measure, signaling that more information is needed to reach a conclusive finding. The BI-RADS system, developed by the American College of Radiology, standardizes breast imaging reports to guide next steps. A BI-RADS 0 score means the initial screening was not sufficient for a clear interpretation.
Common Reasons for Additional Imaging
Several factors can lead to an incomplete mammogram and the need for additional imaging. Technical issues during initial screening, such as patient motion or suboptimal positioning, can result in blurry or incomplete images, preventing the radiologist from clearly visualizing all breast tissue.
Breast density is another frequent reason. Dense breast tissue, which appears white on a mammogram, can obscure potential abnormalities because both dense tissue and potential masses appear similar. Approximately half of all women have dense breasts.
Overlapping breast tissue can also create areas that resemble suspicious findings on a two-dimensional mammogram. Normal tissue can overlap and cast a “summation shadow,” requiring different angles or magnification to confirm its nature.
Sometimes, the radiologist might observe a new area or a change from previous mammograms that requires a closer look. These “unclear findings” indicate the need for more detailed images to ensure an accurate diagnosis. Comparing current images to prior ones is a common practice to identify changes over time.
The Next Steps in Diagnostic Imaging
When an incomplete mammogram necessitates further evaluation, several diagnostic procedures may be employed. A diagnostic mammogram is often the first step, differing from a screening mammogram by taking additional, focused views of the area of concern. This may include magnification views or spot compression. The radiologist is typically present during a diagnostic mammogram to review images in real-time.
Breast ultrasound is another common follow-up tool. This imaging technique uses sound waves to create detailed images and is particularly effective at distinguishing between fluid-filled cysts (benign) and solid masses. Ultrasound is also valuable for guiding biopsies if a suspicious area is identified.
In certain situations, a breast Magnetic Resonance Imaging (MRI) scan may be recommended. Breast MRI uses a powerful magnetic field and radio waves to produce detailed images. It is often used for high-risk individuals or when mammography and ultrasound results are inconclusive.
If, after these additional imaging tests, an area remains concerning, a breast biopsy might be the subsequent step. A biopsy involves removing a small tissue sample from the breast for microscopic examination by a pathologist. It is the definitive method to determine if cells are benign or malignant.
Interpreting Your Mammogram Results
After undergoing additional diagnostic imaging, the results will clarify the nature of the initial incomplete finding. The most common outcome is that the finding is determined to be normal or benign. Many callbacks resolve with the radiologist confirming normal breast tissue, a benign cyst, or another non-cancerous condition.
In some instances, findings may be categorized as probably benign (BI-RADS 3), meaning there is a very low chance of cancer (less than 2%). Short-term follow-up imaging, typically in six months, is recommended to ensure stability and confirm the benign nature of the finding. This approach helps avoid unnecessary biopsies while closely monitoring the area.
A small percentage of incomplete mammograms may lead to a suspicious finding (BI-RADS 4 or 5), prompting a biopsy for a definitive diagnosis. Even with a suspicious finding, many biopsies reveal benign conditions. The follow-up process aims for comprehensive evaluation and accurate diagnosis, with most incomplete results proving non-cancerous.