Following assessment, all cases in Category 1 were composite normal breast tissue (NBT) and returned to normal routine recall. In Category 2, 37 were composite NBT; 19 were real lesions, mostly cysts; four were cancers. In Category 3, 51 were real lesions, mostly cysts; 17 were cancers. This study has demonstrated that in Category 1 cases (definite overcall), no cancers would have been missed. In Category 2 cases (possible overcall), we must accept some overcall as this group can hide subtle cancers. In Category 3 cases (definite recall), almost all warranted recall. The cancers appeared suspicious on screening mammograms. The difference in feature perception between digital and analogue mammography is significant and may alter recall practice. Critical analysis of subtle appearances is required to prevent overcall for future readers.