What happens if we discover a secondary finding in an X-ray?

The aim of the National Programme for Breast Cancer Screening is to detect breast cancer at the earliest possible stage. The specialists who look at the X-rays (screening radiologists) assess them for abnormalities that could be breast cancer. They may accidentally detect something else during this assessment. This is called a secondary finding. The screening radiologist is not looking for that specifically.

A secondary finding is almost never anything serious. If the radiologist finds it useful to further examine the secondary finding, they will inform the GP. Your GP will contact you afterwards If the secondary finding examination offers more disadvantages than benefits, they will not pass the secondary finding on to the GP. You can rely on the radiologist’s knowledge and expertise.

Three types of secondary findings

There are three types of secondary findings. Below we explain how the radiologist handles these.

1. Loose wires from a pacemaker or ICD

When a pacemaker is replaced, the old wires cannot always be removed. They will remain in the body. These old pacemaker wires can sometimes be seen in breast X-rays. These wires are not a reason for further examination. That is why the radiologists do not report this to the GP.

If you have any symptoms, or if you have a pacemaker/ICD and related symptoms, you should always report these symptoms to your GP or cardiologist.

2. Enlarged lymph nodes

The breast X-rays may show (some of) the lymph nodes in the armpit. Sometimes these glands are enlarged. This is usually caused by an infection or by an injury to the hand or arm. An enlarged lymph node may also be an indication of breast cancer. However, the chance of this is very small if there are no other indications of breast cancer visible in the X-ray. Enlarged lymph nodes by themselves are rarely a reason for a follow-up. The radiologist will only report these to the GP in exceptional cases.

If you have any symptoms, or if you feel or see enlarged lymph nodes and have related symptoms, you should always report these symptoms to your GP or cardiologist.

3. Leaking or torn breast implant

It is only by accident that the radiologist will detect a leak or a tear in a breast implant, because they will not be looking for such. In addition, the breast cancer screening method is not the right way to detect problems with a breast implant. If you have no symptoms, a leaking or torn implant is not a reason for further examination. Only in exceptional cases does the radiologist report this to the GP.

If you have any symptoms caused by your implant, you should always report these to your GP or plastic surgeon. If you are concerned about your breast implants, you can make an appointment with your plastic surgeon. They can assess whether further examination is needed.