An abnormal Breast Imaging and Reporting Data System (BIRADS) category 3 mammogram with a short interval follow-up recommendation is a common finding seen in approximately 40% of women for each decade of screening. Factors associated with category 3 mammograms include mammography examination features, tendencies of the interpreting physician, and features of the country's health care system and the screened population including age, family history, previous biopsies, obesity, and menopausal hormone therapy. Recently, the degree to which a BIRADS category 3 mammographic result provides differential breast cancer risk compared with normal mammographic categories (BIRADS category 1 or 2) has been questioned. The yield of category 3 mammographic results could potentially be increased by more uniform performance of additional imaging workup (additional views and/or ultrasonography). In addition, other strategies to more accurately characterize the risk of breast cancer in women with category 3 mammographic results are under evaluation and including magnetic resonance imaging, computer-aided classification systems, and digital tomosynthesis. Given the potential psychologic impact of abnormal mammographic results, studies attempting to more accurately relate screening mammography findings to breast cancer risk are a priority.