- The American Cancer Society recommends mammography to detect breast cancer at an early stage.
- Mammogram results include both benign and malignant findings.
- Results from a screening mammogram may be confirmed by a diagnostic mammogram, breast ultrasound, or breast MRI.
As you brew your morning cup of coffee, your phone rings. It’s your doctor’s office calling with your mammogram results. Your heart started racing, imagining the worst-case scenario. Until the medical assistant says there were no signs of breast cancer. Stay healthy, and we will see you in a year from now for your next screening mammogram. As you hung up the phone, an uncontrollable smile appeared on your lips. It’s a beautiful day.
Later, you start to wonder what would happen if your mammogram results showed something else. The more you know, the more you can prepare. This post will help you to understand potential mammogram results.
What is a mammogram?
A mammogram is an image of your breast tissue. Mammography uses X-rays radiation to create contrast images that reflect your breast density.
Without causing any pain, X-rays will go through your breast tissues and be blocked by dense structures, which appear on the images. The denser the tissue, the whiter it will appear on the mammogram.
The American Cancer Society recommends an annual mammogram to prevent breast cancer. The screening guidelines recommend all women 40 years old and above ask their doctor about getting mammographs periodically.
The idea behind a recurrent screening for breast cancer is to establish a baseline. In other words, it helps to detect any changes that could occur in your breast structures in comparison to your previous exam.
How do healthy breasts look on mammogram results?
Each woman has their own type of breasts. They are different in shapes, size, and structure. These characteristics may also change depending on your hormonal states and your age. For your breast health, it’s crucial to be aware of how your breasts look and feel.
In a general matter, healthy breasts fit in four categories:
- Fatty breasts. This type of breast contains almost entirely fatty tissues and feels consistent throughout the tissue. It appears dark on mammogram images.
- Breasts with fibroglandular areas. These are soft breasts with a sandy feeling in some places.
- Breasts with various densities. Your breast has different textures throughout the tissues. It results in various contrasts on your mammogram.
- Dense breasts. This type of breast feels harder. Because of the dense breast tissue structure, it mainly appears white on the mammogram.
Breast density tends to decrease as you get older, and this is perfectly normal. Your first mammogram will give you and your doctor an idea of your breasts’ characteristics. At each session, your radiologist will compare the most recent results to the previous one to monitor any changes.
What can show up on mammograms?
When your doctor looks at your mammogram’s test results, they are looking for something that looks different from your healthy breast tissues.
Most of the time, you will not find anything significant compared to your previous mammogram report. Your doctor will likely see benign findings like cysts, calcification, or fibroadenoma. But sometimes, the findings are more suspicious and could link to breast cancer.
Cysts are fluid-filled sacs that can appear in your breast. They feel like little water balloons during palpation.
Breast cysts account for about 25% of all breast masses and are usually benign. Because of the fluid they contain, they appear dark on mammographies.
Calcifications are deposits of calcium in breast tissues. A sizable deposit (greater than 0.5 millimeters) is called a macrocalcification while tiny ones (smaller than 0.5 millimeters) are microcalcifications. Because of their high-density structure, calcifications appear as white spots on the mammography images.
The formation of calcifications alone is benign. However, a very localized cluster of misshaped microcalcification is suspicious and could relate to cancer.
Fibroadenoma is a lump in your breast made of fibrous tissue. It is usually no bigger than 2.5 centimeters and moves easily under your skin during palpation. Fibroadenoma is considered a benign breast tumor, but it does not usually increase your risk of developing breast cancer.
This being said, 15% of cases are complex fibroadenoma, which is fibroadenoma combined with cysts and calcifications. These can become breast cancer.
There are various types of breast cancer. The most common type of breast cancer is invasive ductal carcinoma (IDC). It accounts for about 80% of breast cancer cases. In 2020, 276,480 women were diagnosed with IDC. When detected at an early stage, the survival rate is 90%.
IDC usually starts in the milk ducts of the breast. Over time, it may go through the milk duct wall and invade surrounding breast tissues and the lymph nodes.
For early detection and a better prognosis, breast cancer screening through mammograms is recommended. Talk to your doctor about starting active surveillance that includes annual mammograms as part of breast cancer screening.
What is the BI-RADS score?
BI-RADS stands for Breast Imaging Reporting and Data System. The American College of Radiology created this system to evaluate mammograms. The radiologist will score your mammogram from 0 to 6.
- Score 0: Your mammogram is inconclusive. Your doctor may ask you to schedule a diagnostic mammogram for additional imaging. This could be a breast ultrasound (a technique using sound waves) or breast MRI (an imaging technique using magnetic fields and radio waves).
- Score 1: Your mammogram looks normal, and no abnormalities were found in your breast tissues.
- Score 2: A few cysts or calcifications appear on the images, but they’re clearly benign.
- Score 3: The radiologist observed abnormalities that are likely benign. However, you may need a follow-up mammogram within six months to monitor potential changes.
- Score 4: The findings on the mammogram are suspicious. However, the likelihood of cancer is low. Your doctor may ask for a biopsy to analyze a small amount of tissue.
- Score 5: The findings are almost certainly cancerous. You will need a breast biopsy and follow-up tests.
- Score 6: You have a confirmed case of breast cancer.
The BI-RADS score guidelines help your radiologist interpret the results of your mammogram. Comparing your most recent mammogram with your previous mammogram results is another way to get a more accurate diagnosis.
Annual breast cancer screening can save your life.
When your health is on the line, it is important to be as proactive as possible. In addition to a healthy lifestyle with regular exercise and a diet rich in healthy food, screening tests can help keep you well.
At Ezra, we look for technologies that give you the best and trustworthy results. This is why we’re launching a breast cancer screening service in New York that uses three-dimensional imagery, also known as digital breast tomosynthesis.
Three-dimensional imagery captures low-dose images of the breasts from different angles, which results in up to 300 pictures as opposed to only four from 2D mammograms. Research shows this method catches more cancer.
If you are a woman reaching your 40s, chat with your health care provider about beginning annual screenings. Your doctor will help you understand your risk of breast cancer and prescribe regular mammograms.
Once you start your breast health surveillance journey, your doctor and radiologist will help you understand your mammogram results and answer any of your questions about mammograms.