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What if They Think They See Something on My Mammogram

(Also Called 'Breast Self-exam')

"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?

Many women choose to have yearly screening mammograms starting at the age of 40. Screening mammograms are done for women who have no signs or symptoms related to the breasts (asymptomatic).

mammogram

Position of breast during mammography

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 to 8 percent of women who have screening mammograms. This 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. Magnification views are often done to get a better picture of the area of concern. These mammograms are also done for women who have signs or symptoms related to the breasts. 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 are usually recommended for dense breast tissue or for women under the age of 50. The films 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 finding seen on a mammogram. Most microcalcifications are benign. They can be classified as benign, suspicious, or indeterminate. Depending on the appearance of the microcalcifications, a biopsy might be recommended after the additional studies (magnification views).

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

The best opportunity for a positive outcome is early detection. Breast cancer is often curable if detected at an early stage. It is helpful for women to be familiar with how their breasts feel. Any new areas of concern should be reported to your health care provider.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/1/2013...#4751


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