"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 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 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 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
- Have a mammogram once a year
If you are noted to be at high risk for breast cancer, you may start your
screening earlier. Check with your doctor about this.
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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: 2/17/2009...#4751
