What if the radiologist sees something suspicious or abnormal on your mammogram? The fear of abnormal mammogram results is real, but facts may help calm it. Most abnormalities found in mammogram results are not breast cancer.
The American Cancer Society recommends having a baseline mammogram between ages 35 and 40, and then a screening mammogram every year after age 40. Questionable mammogram results sometimes require additional evaluation. With further examination (imaging studies and/or biopsy), most of these 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, even if they are asymptomatic, meaning that they have no signs or symptoms of breast disease.
In a screening mammogram, each breast is X-rayed in two different positions: from top to bottom and from side to side. When a mammogram image is viewed, breast tissue appears white and opaque and fatty tissue appears darker and translucent.
What If Something Looks Abnormal?
Potential abnormalities are found in 6% to 8% percent of women who have screening mammograms. This small group of women needs further evaluation that may include diagnostic mammography, breast ultrasound, or needle biopsy.
After the additional evaluation is complete, most of these women will be found to have nothing wrong.
What Is a Diagnostic Mammogram?
Diagnostic mammograms differ from screening mammograms in that the examination focuses specifically on an area of tissue that appeared abnormal in a screening mammogram. Diagnostic mammograms are also done for women who haven't had a screening mammogram but may be showing signs or symptoms of something abnormal in the breasts.
Depending on the potential abnormality, different studies may be done. In some women, only additional mammographic images are needed. In other women, additional mammographic images and an ultrasound are done.
How Does an Abnormality Appear on a Mammogram?
A potential abnormality on a mammogram may 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) may be cancerous and a biopsy is usually recommended.
Microcalcifications (small deposits of calcium) are another type of abnormality. They can be classified as benign, suspicious or indeterminate. Depending on the appearance of the microcalcifications on the additional studies (magnification views), a biopsy may be recommended.
How Accurate Is Mammography?
Mammography is 85% to 90% accurate. Mammograms have improved the ability to detect breast abnormalities before they are large enough to be felt during a breast examination.
However, it is possible for a mass to be felt but not appear on a mammogram. Because of this, your healthcare provider should evaluate any abnormality that you feel when examining your breasts. A diagnostic mammogram or additional studies may be recommended.
Thursday, November 8, 2007
Breast Cancer: Mammograms
Mammography uses special X-ray images to detect abnormal growths or changes in the breast tissue. Mammograms performed on healthy, normal breasts provide a baseline reference for later comparison.
Using a machine and X-ray film made especially for breast tissue, a technician compresses the breast and takes pictures from at least two different angles, creating a set of images for each of your breasts. This set of images is called a mammogram. Breast tissue appears white and opaque and fatty tissue appears darker and translucent.
In a screening mammogram, the breast is X-rayed from top to bottom and from side to side. A diagnostic mammogram focuses in on a particular lump or area of abnormal tissue.
Why Do I Need a Mammogram?
Mammograms are performed as part of a regular physical exam or to evaluate any unusual changes in the breast.
A mammogram can help your healthcare provider decide if a lump, growth or change in your breast needs further testing. The mammogram is also used to look for lumps that are too small to be felt during a physical exam.
Why Should I Get a Mammogram?
Mammography is your best defense against breast cancer because it can detect the disease in its early stages, before it can be felt during a breast examination. Research has clearly shown that mammography can increase breast cancer survival.
How Should I Prepare For a Mammogram?
Inform your doctor or the technician performing the test if you are pregnant or think that you may be.
No dietary changes are necessary. Take your medicines as usual.
Do not wear body powder, cream, deodorant or lotion on your chest the day of the test. These substances may interfere with the X-rays.
You will be asked to remove all clothing above the waist and you will be given a hospital gown to wear. You may want to wear a two-piece outfit the day of the test.
You will be asked to remove all jewelry.
Using a machine and X-ray film made especially for breast tissue, a technician compresses the breast and takes pictures from at least two different angles, creating a set of images for each of your breasts. This set of images is called a mammogram. Breast tissue appears white and opaque and fatty tissue appears darker and translucent.
In a screening mammogram, the breast is X-rayed from top to bottom and from side to side. A diagnostic mammogram focuses in on a particular lump or area of abnormal tissue.
Why Do I Need a Mammogram?
Mammograms are performed as part of a regular physical exam or to evaluate any unusual changes in the breast.
A mammogram can help your healthcare provider decide if a lump, growth or change in your breast needs further testing. The mammogram is also used to look for lumps that are too small to be felt during a physical exam.
Why Should I Get a Mammogram?
Mammography is your best defense against breast cancer because it can detect the disease in its early stages, before it can be felt during a breast examination. Research has clearly shown that mammography can increase breast cancer survival.
How Should I Prepare For a Mammogram?
Inform your doctor or the technician performing the test if you are pregnant or think that you may be.
No dietary changes are necessary. Take your medicines as usual.
Do not wear body powder, cream, deodorant or lotion on your chest the day of the test. These substances may interfere with the X-rays.
You will be asked to remove all clothing above the waist and you will be given a hospital gown to wear. You may want to wear a two-piece outfit the day of the test.
You will be asked to remove all jewelry.
Breast Cancer: Doctor's Breast Exam
A breast examination by a health professional (such as your doctor, nurse, nurse practitioner or physician assistant) is an important part of routine physical checkups.
How Often Should I Have a Clinical Breast Exam?
You should have a clinical exam at least every three years starting at age 20 and every year starting at age 40. A clinical breast exam may be recommended more frequently if you have a strong family history of breast cancer.
When Should I Schedule a Clinical Breast Exam?
Breast exams are best performed soon after your menstrual period ends, because your breasts will not be as tender and swollen as during your period. This makes it easier to detect any unusual changes. If you have stopped menstruating, schedule the yearly exam on a day that's easy for you to remember, such as your birth date.
What Happens During a Breast Physical Exam?
Your healthcare provider will ask you detailed questions about your health history, including your menstrual and pregnancy history. Questions might include what age you started menstruating, if you have children and how old you were when your first child was born.
A thorough breast exam will be performed. For the exam, you undress from the waist up. Your healthcare provider will look at your breasts for changes in size or shape. Your provider may ask you to lift your arms over your head, put your hands on your hips or lean forward. He or she will examine your breasts for any skin changes including rashes, dimpling or redness. This is a good time to learn how to do a breast self-exam if you don't already know how.
As you lay on your back with your arms behind your head, your healthcare provider will examine your breasts with the pads of the fingers to detect lumps or other changes. The area under both arms will also be examined.
Your healthcare provider will gently press around your nipple to check for any discharge. If there is discharge, a sample may be collected for examination under a microscope.
Complete Breast Cancer Screening
Clinical and breast self-examination are important methods of early breast cancer detection and should be performed along with mammography. All three of these methods provide complete breast cancer screening.
How Often Should I Have a Clinical Breast Exam?
You should have a clinical exam at least every three years starting at age 20 and every year starting at age 40. A clinical breast exam may be recommended more frequently if you have a strong family history of breast cancer.
When Should I Schedule a Clinical Breast Exam?
Breast exams are best performed soon after your menstrual period ends, because your breasts will not be as tender and swollen as during your period. This makes it easier to detect any unusual changes. If you have stopped menstruating, schedule the yearly exam on a day that's easy for you to remember, such as your birth date.
What Happens During a Breast Physical Exam?
Your healthcare provider will ask you detailed questions about your health history, including your menstrual and pregnancy history. Questions might include what age you started menstruating, if you have children and how old you were when your first child was born.
A thorough breast exam will be performed. For the exam, you undress from the waist up. Your healthcare provider will look at your breasts for changes in size or shape. Your provider may ask you to lift your arms over your head, put your hands on your hips or lean forward. He or she will examine your breasts for any skin changes including rashes, dimpling or redness. This is a good time to learn how to do a breast self-exam if you don't already know how.
As you lay on your back with your arms behind your head, your healthcare provider will examine your breasts with the pads of the fingers to detect lumps or other changes. The area under both arms will also be examined.
Your healthcare provider will gently press around your nipple to check for any discharge. If there is discharge, a sample may be collected for examination under a microscope.
Complete Breast Cancer Screening
Clinical and breast self-examination are important methods of early breast cancer detection and should be performed along with mammography. All three of these methods provide complete breast cancer screening.
Breast Cancer: Breast Self-Exam
The most effective way to fight breast cancer is to detect it early. A breast self-exam may help, although the most effective tools to detect breast cancer are mammography and clinical breast exam by your health professional. In fact, women who perform regular breast self-exams find 90% of all breast masses.
What Is a Breast Self-Exam and Why Should I Do It?
The breast self-exam is a way that you can check your breasts for changes (such as lumps or thickenings) that may signal breast cancer. When breast cancer is detected in its early stages, your chances for surviving the disease are greatly improved. While 80% of all breast lumps are not cancerous, you can help catch potentially serious changes in the breast early by regularly performing a self-exam.
When Should I Perform a Breast Self-Exam?
It is good to start performing breast self exams in your 20's. You should examine your breasts once a month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month, such as the first day of the month or a day easy for you to remember, such as your birth date. With each exam, you will become familiar with the contours and feel of your breasts, and will be more alert to changes.
What Is a Breast Self-Exam and Why Should I Do It?
The breast self-exam is a way that you can check your breasts for changes (such as lumps or thickenings) that may signal breast cancer. When breast cancer is detected in its early stages, your chances for surviving the disease are greatly improved. While 80% of all breast lumps are not cancerous, you can help catch potentially serious changes in the breast early by regularly performing a self-exam.
When Should I Perform a Breast Self-Exam?
It is good to start performing breast self exams in your 20's. You should examine your breasts once a month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month, such as the first day of the month or a day easy for you to remember, such as your birth date. With each exam, you will become familiar with the contours and feel of your breasts, and will be more alert to changes.
Breast Cancer: Screening and Detection Overview
When it comes to breast cancer detection, not all medical institutions and advocacy groups agree on when women should start getting regular breast cancer screening mammograms.
The lifetime risk (to age 85) of a woman developing breast cancer in 1940 was 5% or one in 20; the risk is now 13.4% or almost one in 8. In women 40 to 49 years of age, there is a one in 68 risk of developing breast cancer, compared with a one in 37 risk among women in the 50 to 59 year age group.
Women who undergo breast cancer screening mammograms have demonstrated significantly reduced deaths from the disease.
Women between the ages of 40 to 49 live longer if they undergo breast cancer screening, even though the reductions in deaths from breast cancer mortality are delayed for 10 to 15 years after diagnosis.
The benefit of mammography is related to early detection. Regardless of how advanced the cancer is when it is detected, more than 90% of women live longer than 10 years after the diagnosis (in women 40 to 74 years old diagnosed with tumors that are 10 millimeters or smaller in size).
The effectiveness of any breast cancer screening program will depend on how often women are screened, compliance with screening recommendations and the quality of the screening test.
Recommendations for Breast Cancer Screening by The Cleveland Clinic Experts
The following are the recommendations for breast cancer screening:
Monthly breast breast self-examination starting at age 20.
Breast examination by a health-care provider every three years starting at age 20; annual clinical breast exam starting at age 40.
Annual screening mammography starting at age 40.
Women in high-risk categories may want to consider starting screening at age 30.
The lifetime risk (to age 85) of a woman developing breast cancer in 1940 was 5% or one in 20; the risk is now 13.4% or almost one in 8. In women 40 to 49 years of age, there is a one in 68 risk of developing breast cancer, compared with a one in 37 risk among women in the 50 to 59 year age group.
Women who undergo breast cancer screening mammograms have demonstrated significantly reduced deaths from the disease.
Women between the ages of 40 to 49 live longer if they undergo breast cancer screening, even though the reductions in deaths from breast cancer mortality are delayed for 10 to 15 years after diagnosis.
The benefit of mammography is related to early detection. Regardless of how advanced the cancer is when it is detected, more than 90% of women live longer than 10 years after the diagnosis (in women 40 to 74 years old diagnosed with tumors that are 10 millimeters or smaller in size).
The effectiveness of any breast cancer screening program will depend on how often women are screened, compliance with screening recommendations and the quality of the screening test.
Recommendations for Breast Cancer Screening by The Cleveland Clinic Experts
The following are the recommendations for breast cancer screening:
Monthly breast breast self-examination starting at age 20.
Breast examination by a health-care provider every three years starting at age 20; annual clinical breast exam starting at age 40.
Annual screening mammography starting at age 40.
Women in high-risk categories may want to consider starting screening at age 30.
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