For some, October means pumpkin spice lattes, trips to the cider mill, and the start of sweater weather. For many others, it is synonymous with Breast Cancer Awareness Month, a time to reflect on and honor the journey they, or their loved ones, walked after a breast cancer diagnosis. It may come with celebration and gratitude. It may also come with grief or the quiet weight of waiting for results. Above all, it is a reminder of every effort poured into fighting this disease, woven from countless acts of courage, compassion, and perseverance.
As a medical oncologist, I meet people at every stage of a breast cancer diagnosis, and I often ask them how their cancer was discovered. For many, the answer is a routine screening mammogram. Screening has shifted most breast cancers to an earlier, more treatable stage, and many are small enough that they could never have been felt. For others, the cancer was advanced by the time it was found, and the mammogram was where the path to treatment, and often to cure, began. But a mammogram is only part of the story. What happens afterwards matters just as much.
A mammogram is an important first step, but it isn’t always the last one. Sometimes the first images show something the radiologist wants to look at more closely, which may mean a diagnostic mammogram, an ultrasound, or an MRI. What I can’t stress enough is this: after your mammogram, make sure you get a green light, meaning you know you’re all clear until your next screening. Before you leave your appointment, ask, “Do I need anything else, and when will I hear back?” If you haven’t heard back when they said you would, call. That follow-through is just as important as showing up in the first place.
About 1 in 10 women are called back for additional imaging after a screening mammogram.¹ If you get that call or letter, take a breath. It isn’t a diagnosis, just a reminder that a few extra steps are needed this year. I’ve had patients tell me, “I was supposed to schedule the ultrasound, I just never got around to it.” Life gets busy, but a few months can quietly turn into much longer. Most of the time, the extra pictures simply help the radiologist take a better look at something that turns out to be benign or worth watching.
One more thing worth a look: your mammogram results letter now includes your breast density, a line that’s easy to skim past. Dense tissue can make mammograms harder to read and is linked to higher risk, so if your letter says dense, bring it up with your doctor and ask whether additional imaging makes sense for you.
A normal mammogram doesn’t replace listening to your body. Some women go to their screenings, they pay attention to their bodies, and a few months after a normal mammogram, they notice something new, such as a lump, nipple discharge, breast pain, skin dimpling or redness, a nipple that turns inward, or a change in the size or shape of a breast. Cancers found between screenings are called interval cancers, and they make up roughly 20-30% of breast cancers diagnosed in women who are being screened.² Most breast changes turn out to be benign, but the only way to know is to get them checked. Call your doctor early rather than waiting for your next screening. We would always rather see you for something that turns out to be nothing.
Prevention is key, and attainable. Several factors are linked to a higher risk of breast cancer, especially after menopause: carrying extra weight, drinking alcohol, being physically inactive, and using hormone replacement therapy.³ Still, many women who develop breast cancer have none of these factors, and many who have them never will. Small, sustainable changes, like moving a little more or having fewer drinks each week, can meaningfully shift your risk over time. If you’re on hormone therapy, talk it through with your medical team before making any changes, since the right choice depends on your symptoms and overall health. It’s also worth asking your doctor to assess your personal breast cancer risk, including family history. For women at higher risk, options include closer monitoring and medications that lower risk.
Breast cancer touches many of us, whether it’s our own diagnosis or that of someone we love. What gives me hope is that we have more tools than ever. Finding breast cancer early often means gentler treatment and better odds of cure, and it can open the door to genetic counseling that helps protect family members too. So, this October, between the cider mill and the sweater weather, make room for one appointment. Your care team is on your side, and we’re glad to take the next step with you.
Dr. Rebecca Chacko
Henry Ford Health
- Sprague, B. L., Coley, R. Y., Kerlikowske, K., Rauscher, G. H., Henderson, L. M., Onega, T., ... & Miglioretti, D. L. (2020). Assessment of radiologist performance in breast cancer screening using digital breast tomosynthesis vs digital mammography. JAMA Network Open, 3(3), e201759.
- Hoff, S. R., Abrahamsen, A. L., Samset, J. H., Vigeland, E., Klepp, O., & Hofvind, S. (2012). Breast cancer: missed interval and screening-detected cancer at full-field digital mammography and screen-film mammography—results from a retrospective review. Radiology, 264(2), 378-386.
- Baxter NN, Phillips KA. Unlocking the potential of risk-based screening for breast cancer: from detection to prevention. JAMA. 2026;335(9):758-760. doi:10.1001/jama.2025.24817