What If They See Something On My Mammogram?

Are you worried about the doctor finding something on your mammogram? Our physicians share when to worry and not to worry.

"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.

Women should get annual mammograms starting at age 45 and personalized. Some women can wait until age 50 to begin screening mammograms and have them done every 2 years. High risk women need more intensive screening.

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 individually for women. 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:

1. From top to bottom
2. 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 6-8% of women who have screening mammograms. This small group of women needs 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.

What is a Digital Mammogram?

Digital mammograms are newer technology films that use the computer to produce your images. The equipment is very much like a digital camera. The equipment can see things better, especially in terms of dense breast. Digital mammograms cannot be lost. However, the amount of compression and radiation is the same as analog films.

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. Most microcalcifications are benign. They 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.

How Accurate is Mammography?

Mammography is 85 percent to 90 percent accurate. Mammograms have improved the ability to detect breast abnormalities before they are large enough to be felt. However, it is possible that a mass that can be felt (palpable) might not be seen on a mammogram. Any abnormality that you feel when examining your breasts should be evaluated by your health care provider. A diagnostic mammogram might be recommended.

Monthly self-examination is essential

The best opportunity for a positive outcome is early detection. Breast cancer might be curable if detected at an early stage.

Every woman should follow the American Cancer Society’s breast screening recommendations listed below.

American Cancer Society Breast Screening Guidelines

If you are between the ages of 20 and 40, you should:

• Do a breast self-exam once a month
• Have a breast physical examination by your health care provider every three years

If you are age 40 or older, you should:

• Do a breast self-exam once a month
• Have a breast physical examination by your health care provider once a year
• Discuss mammogram screening with your physician

If you are noted to be at high risk for breast cancer, you may start your screening earlier. Check with your doctor about this.

What is Breast Tomosynthesis?

This a method of imaging the breast in three dimensions (3D) using xrays. It may help to increase the sensitivity of screening mammograms. Not all health systems have tomosynthesis and not every woman needs tomosynthesis to screen for breast cancer.