Imaging Abnormalities

Mammograms, ultrasounds, and MRIs can turn up masses, calcifications, and areas of distortion that need a closer look before anyone can say what they are. Sarah Waterman, MD, at Green Mountain Breast Care Center in Stowe, Vermont, works up these findings with additional imaging and biopsy when needed. Call the Stowe office or request an appointment online to have an abnormal result evaluated.

What counts as an imaging abnormality?

An imaging abnormality is anything on a mammogram, ultrasound, or MRI that looks different from the surrounding tissue or from your previous scans. Radiologists flag these findings for further evaluation, which does not mean cancer was found.

Roughly 10% of women who have a screening mammogram get called back for additional imaging, and only a small fraction of those callbacks lead to a cancer diagnosis. First mammograms produce more callbacks than later ones, since there is nothing to compare against.

What kinds of imaging abnormalities show up on a breast scan?

Dr. Waterman evaluates several types of findings:

• Masses, which may be solid or fluid-filled
• Calcifications, tiny calcium deposits in the tissue
• Asymmetries, where one breast shows more density in an area
• Architectural distortion, where tissue appears pulled or twisted
• Skin or nipple thickening
• Enlarged lymph nodes

Your radiology report assigns a Breast Imaging Reporting and Data System (BI-RADS) category from 0-6. 

Radiologists use this scale to describe how suspicious a finding looks, with 0 meaning more imaging is needed, 1 and 2 indicating a normal or benign result, and higher numbers signaling that a biopsy or further workup makes sense. The category tells Dr. Waterman what to recommend next.

How does my doctor work up imaging abnormalities?

Additional imaging comes first. Diagnostic mammography takes more detailed pictures of the specific area, and ultrasound distinguishes fluid-filled cysts from solid masses. Dr. Waterman may order an MRI when your breast tissue is dense or the findings remain unclear.

Many callbacks end here. The finding turns out to be overlapping tissue, a cyst, or a benign change, and you return to your regular screening schedule.

When do imaging abnormalities require a biopsy?

When imaging can’t settle the question, Dr. Waterman recommends a biopsy to examine the tissue directly. She performs image-guided biopsies using ultrasound, mammography, or MRI to target the exact area, and the procedure takes place in the office under local anesthesia.

Pathology results usually come back within a few days. Dr. Waterman reviews them with you, explains what they mean, and outlines your next step, whether that means treatment, closer monitoring with follow-up imaging in six months, or a return to routine screening.

Call Green Mountain Breast Care Center today or request an appointment online to learn more.