"They think they see something on my mammogram."
The fear this sentence evokes is real, but can be quieted by facts. Most
abnormalities on a mammogram are NOT breast cancer.
Most women will have annual screening mammograms starting at the age of 40. On a
screening mammogram, questionable abnormalities sometimes require additional evaluation.
With further examination, most of these questionable abnormalities are found to be normal
breast tissue or benign (non-cancerous) tissue.
What is a screening mammogram?
Screening mammograms are recommended annually for all women starting at age 40.
Screening mammograms are also done for women who have no signs or symptoms related to the
breasts (asymptomatic).
During a screening mammogram, the breast is X-rayed in two different positions: from top to
bottom and from side to side. When a mammogram is viewed, breast tissue appears white and
opaque, and fatty tissue appears darker and translucent.
A potentially abnormal screening mammogram
Potential abnormalities are found in 6 percent to 8 percent of women who have screening
mammograms. This small group of women need further evaluation that might include breast
physical examination, diagnostic mammography, breast ultrasound, or needle biopsy.
After the additional evaluation is complete, most women who have potential
abnormalities on a screening mammogram will be found to have nothing wrong.
What is a diagnostic mammogram?
Diagnostic mammograms are done for women who have potential abnormalities
detected on a screening mammogram. These mammograms are also done for women who have signs or symptoms related to the
breasts (symptomatic). Diagnostic mammograms differ from screening mammograms in that the potential
abnormality or symptom is the focus of the examination.
Depending on the potential abnormality, different studies might be done. In some women,
only additional mammographic images are needed. In other women, additional mammographic
images and an ultrasound are done.
How does an abnormality appear on a mammogram?
A potential abnormality on a mammogram might be called a nodule, mass, lump,
density, or distortion.
A mass (lump) with a smooth, well-defined border is often benign. Ultrasound is needed
to characterize the inside of a mass. If the mass contains fluid, it is called a cyst.
A mass (lump) that has an irregular border or a star-burst appearance (spiculated)
might
be cancerous, and a biopsy is usually recommended.
Microcalcifications (small deposits of calcium) are another type of abnormality.
Microcalcifications can be classified as benign, suspicious, or indeterminate. Depending on
the appearance of the microcalcifications on the additional studies (magnification views),
a biopsy might be recommended.