How to Write a Mammography Recall (Callback) Letter Patients Respond To

A recall letter has one job: get a patient who needs additional imaging to actually come back. It sounds simple, but the wording carries real weight. Say too little and the patient panics or ignores it; say it badly and she doesn’t understand what to do next. This guide covers what a good callback letter says, how to keep it calm and clear, and a structure you can adapt.

This article is general information, not legal advice. Confirm requirements against current FDA/MQSA guidance and your state’s rules.

What a recall (callback) letter is and isn’t

A recall letter goes to a patient whose screening mammogram was assessed BI-RADS 0 Incomplete, meaning the images need additional views or ultrasound before a final read. It is not a cancer diagnosis. In fact, the great majority of callbacks resolve as normal or benign: a BI-RADS 0 is reclassified to BI-RADS 1 or 2 in over 70% of cases after the follow-up imaging.

That context matters because the national callback rate runs about 10–12% of screening mammograms. Roughly one in nine women you screen gets one of these letters, so the letter is a high-volume, high-stakes piece of routine communication, not an edge case.

The number-one rule: write for reassurance and clarity

The biggest lever you have is readability. A study of screening-recall lay letters found that improving readability raised the share of patients who followed up within 60 days from about 90% to nearly 94%. Small wording changes move real follow-up behavior.

Two failure modes to avoid:

Too clinical. “Your examination yielded a BI-RADS category 0 assessment necessitating supplementary diagnostic imaging” makes patients reach for Google and fear the worst.
Too vague. “Please call us” with no reason and no urgency gets filed and forgotten.

Aim for roughly a 6th–8th grade reading level, short sentences, and a single clear action.

What every callback letter should contain

A plain-language statement of why she’s getting the letter: her screening mammogram needs a closer look with additional images; this is common and usually not cancer.
Explicit reassurance with honest framing. Most women called back do not have cancer, but the additional imaging is important and shouldn’t be skipped.
One clear next step: call this number, or that we’ll call to schedule; include hours and a direct line.
A timeframe: when to call by, so it doesn’t drift.
What to bring / expect: prior images, how long the visit takes.
A contact for questions: a real person or department.

Don’t rely on a single letter

The best-practice workflow isn’t one letter and done. A proven cadence:

Mail the lay-language recall letter promptly after the BI-RADS 0 read.
Have a staff member call the patient to schedule, rather than waiting for her to call in.
Escalate non-responders. If no appointment is made within about four weeks, send a second, firmer notice (often by certified mail) so there’s a record of the attempt.

That escalation ladder is both better care and better documentation if follow-up is ever questioned.

A simple structure you can adapt

Dear [Patient name],

Thank you for your recent mammogram at [Facility]. Your screening showed an area we’d like to look at more closely with a few additional images. This is common and most often is not cancer, about 1 in 10 women is asked to come back, and the large majority turn out to be normal.

Please call us at [direct number] by [date] to schedule your follow-up visit, or we will call you within [X] days to set it up. The visit usually takes about [X] minutes. If you have prior mammogram images from another facility, please bring them.

If you have any questions, call [name/department] at [number]. We’re glad to help.

Keep it on facility letterhead, signed by a named contact, and make the phone number impossible to miss.

Doing this reliably at volume

At a 10–12% callback rate, a busy center generates these letters constantly alongside the 30-day results letters every patient gets and the new breast-density notifications. Producing them by hand, on time, with a record of each send is where staff time disappears.

PatientLetterHub generates recall, results, and density letters from your data in lay-readable language and mails them on a predictable schedule, with a record of every notification. See how it works.

Frequently asked questions

What is a mammogram callback letter? A letter notifying a patient that her screening mammogram (BI-RADS 0) needs additional imaging before a final result. It is not a cancer diagnosis.

How common are mammogram callbacks? About 10–12% of screening mammograms in the U.S. result in a callback. Most resolve as normal or benign.

What reading level should a recall letter be? Aim for roughly 6th–8th grade. Clearer letters measurably improve follow-up rates.

Should we also call the patient? Yes. A proactive scheduling call plus an escalation notice for non-responders outperforms a single mailed letter.