Finding cancerous cells in a mammogram
The radiologist will classify your breast density using four categories:. When breasts are mostly fatty, the tissue on the mammogram is dark and transparent. That makes it easy to detect abnormalities, which generally show up as white. Dense breast tissue appears solid white on a mammogram. Tumors and other masses also look white, so that makes it harder to detect abnormalities.
Many women have dense breasts. Usually, but not always, your breasts get less dense as you age. Some states require providers to notify women that they have dense breasts.
Everything You Need To Know About Your Mammogram
You can have dense breasts and still have a negative mammogram result. A negative result means nothing abnormal was detected. There were no distortions, calcifications, or lumps, and the breasts appear symmetrical. Deposits of calcium in the breast are called breast calcifications. Macrocalcifications look like large white dots or lines. Microcalcifications look like tiny white specks, usually clustered together. Most are noncancerous, but sometimes they can be an early indicator of cancer.
But you might be asked to have a follow-up mammogram in 6 months to see if anything changes. You can also develop fibrosis or cysts. Fibrosis is when you have a lot of fibrous tissue. When you touch a fibrous area, it feels firm or rubbery. Cysts are fluid-filled sacs that have a smooth, well-defined border. If a cyst grows large enough, it can stretch your breast tissue.
Fibrocystic changes are more likely to occur during your childbearing years. They might be more noticeable just before you have a period. Your doctor may want to order another mammogram or an ultrasound to investigate fibrocystic changes.
Suspicious Mammogram Result: Now What?
A cancerous breast tumor is usually irregularly shaped. Most cancerous tumors are also painless. A biopsy is needed to confirm a diagnosis. Mammograms with this score are used to monitor breast cancer treatment. If you have breast implants, you should still have screening mammograms. A mammogram is a breast x-ray. During your appointment, a mammographer an expert in taking breast x-rays will ask you to undress to the waist and stand in front of the mammogram machine.
Your breasts will be placed one at a time on the x-ray machine. The breast will be pressed down firmly on the surface by a clear plate. At least two pictures of each breast will be taken, one from top to bottom and then a second from side to side to include the part of your breast that extends into your armpit.
You will need to stay in this position while the x-ray is taken. Mammograms are not often used in women under However, for some women under 40, mammograms may still be needed to complete the assessment. Some people worry about the amount of radiation used in mammograms. Digital breast tomosynthesis DBT is another, more detailed type of mammogram used in some hospitals. DBT makes 3D images using x-rays. The breast is positioned the same way as when having a mammogram.
Follow-Up After An Abnormal Mammogram | Susan G. Komen®
The x-ray arm rotates and curves around the breast, taking multiple x-ray pictures at different angles. The information is then sent to a computer where it makes the pictures into 3D images 3D mammogram. This can make it easier to see any overlapping breast tissue more clearly. To help gain a clear image of the breast, some gel will be spread over the area of the breast first. The person doing the scan will move a handheld scanning probe over the breast to look at the underlying breast tissue.
The area under your arm axilla may also be scanned. You may hear your results described as a letter and a number. Having a breast examination, breast imaging for example, a mammogram or an ultrasound scan and tissue removed for example, a core biopsy or FNA is known as a triple assessment. This is usually all that is needed to make a diagnosis.
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If this is the case you may be called back at a later date for one or more of the following tests. Although mammograms are usually the best way of detecting any early changes within the breast, sometimes other imaging techniques are used as well. This could include:. You may hear about different techniques used to take pictures of the breasts.
Mammography plays a central part in early detection of breast cancers because it can often show changes in the breast before a patient or physician can feel them. Research has shown that annual mammograms can lead to early detection of breast cancers when they are most curable and breast-conservation therapies are available. A mammogram may also find ductal carcinoma in situ DCIS , abnormal cells in the lining of a breast duct that may develop into invasive cancer.
Mammography is the only breast cancer screening tool known to reduce deaths from the disease.
Supplemental Breast Cancer Screening Many studies have shown that ultrasound and magnetic resonance imaging MRI can help supplement mammography by detecting breast cancers that may not be visible with mammography. MRI of the breast may be used for women at high risk for breast cancer, typically because of a strong family history of the disease. Ultrasound of the breast may be used for women who are at high risk for breast cancer and unable to undergo an MRI examination or women who are pregnant and should not be exposed to x-rays used in mammography.
Ultrasound of the breast can also be used to screen women who have dense breast tissue, meaning there are a lot of ducts, glands, fibrous tissue and less fat making it harder to find cancers with traditional mammography. About Breast Cancer Breast Cancer is cancer that forms in tissues of the breast, usually in the ducts tubes that carry milk to the nipple and lobules glands that make milk.
Clinical Breast Exam In a clinical breast exam, the doctor carefully feels the breasts and underarm area for lumps or anything else unusual. Screening Mammography Mammography is a type of x-ray examination used to examine the breasts. Breast Tomosynthesis Breast tomosynthesis , also called three-dimensional 3-D mammography, is an advanced type of breast imaging that uses low-dose x-rays and computer reconstruction to create images of the breast.
Breast Ultrasound Breast ultrasound is a type of imaging that uses sound waves to create pictures of the inside of the breast. Breast MRI During breast MRI, a powerful magnetic field, radio frequency pulses and a computer are used to produce detailed pictures of the inside of the breasts.
Mammography Benefits Imaging the breast improves a physician's ability to detect small tumors. When cancers are small, the woman has more treatment options. The use of screening mammography increases the detection of small abnormal tissue growths confined to the milk ducts in the breast, called ductal carcinoma in situ DCIS. These early tumors rarely harm patients if they are removed at this stage, and mammography is the only proven method to reliably detect these tumors. It is also useful for detecting all types of breast cancer, including invasive ductal and invasive lobular cancer.
Mammography has been shown to decrease the number of deaths from breast cancer when it is used for screening.
How Is Breast Cancer Diagnosed?
No radiation remains in a patient's body after an x-ray examination. Risks There is always a slight chance of cancer from excessive lifetime exposure to radiation. However, the amount of radiation from a mammogram is very small and the benefit of an accurate diagnosis far outweighs the risk. The effective radiation dose for this procedure varies. See the Safety page for more information about radiation dose.
False positive mammograms may occur.
Five to 15 percent of screening mammograms require more testing such as additional mammograms or ultrasound. Most of these tests turn out to be normal. If there is an abnormal finding, a follow-up or rarely a biopsy may have to be performed. Most biopsies are done with a needle and confirm that no cancer was present. Based on statistical studies on the incidence of cancer over time, some researchers have suggested that cancer screening identifies both life-threatening diseases and diseases that would never have caused symptoms during the patient's lifetime, a phenomenon called over-diagnosis.
Overdiagnosis of breast cancer is likely very small. Scientists are working on methods to classify abnormal cells according to their potential to cause harm; however, at this time, physicians have no way of distinguishing non-life threatening cancer cells from those that will cause advanced disease. Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant.