What the doctor looks for on your mammogram

What the doctor looks for on your mammogram

The doctor reading your mammogram will look for several types of changes:
Calcifications are tiny mineral deposits within the breast tissue, which look like small
white spots on the films. They may or may not be caused by cancer. There are 2 types of
calcifications:
· Macrocalcifications are coarse (larger) calcium deposits that are most likely changes
in the breasts caused by aging of the breast arteries, old injuries, or inflammation.
These deposits are related to non-cancerous conditions and do not require a biopsy.
About half the women over 50, and in about 1 of 10 women under 50 have
macrocalcifications.
· Microcalcifications are tiny specks of calcium in the breast. They may appear alone
or in clusters. Microcalcifications seen on a mammogram are of more concern, but
still usually do not mean that cancer is present. The shape and layout of
microcalcifications help the radiologist judge how likely it is cancer is present. If the
calcifications look suspicious for cancer, a biopsy will be done.
A mass, which may occur with or without calcifications, is another important change
seen on a mammogram. Masses can be many things, including cysts (non-cancerous,
fluid-filled sacs) and non-cancerous solid tumors (such as fibroadenomas), but they could
also be cancer.
Cysts can be simple fluid-filled sacs (known as simple cysts) or can be partially solid
(known as complex cysts). Simple cysts are benign and don’t need to be biopsied. Any
other type of mass (such as a complex cyst or a solid tumor) might need to be biopsied to
be sure it isn’t cancer.
· A cyst and a tumor can feel alike on a physical exam. They can also look the same on
a mammogram. To confirm that a mass is really a cyst, a breast ultrasound is often
done. Another option is to remove (aspirate) the fluid from the cyst with a thin,
hollow needle.
· If a mass is not a simple cyst (that is, if it is at least partly solid), then you may need
to have more imaging tests. Some masses can be watched with periodic
mammograms, while others may need a biopsy. The size, shape, and margins (edges)
of the mass help the radiologist determine if cancer is present.

Having your previous mammograms available for the radiologist is very important. They
can show that a mass or calcification has not changed for many years. This would mean
that it is probably a benign condition and a biopsy is not needed.
Your mammogram report may also contain an assessment of breast density or state that
you have “dense breasts.” Breast density is based on how much of your breast is made up
fatty tissue vs. how much is made up of fibrous and glandular tissue.
Dense breasts are not abnormal. Although dense breast tissue can make it harder to find
cancers on a mammogram, at this time, experts do not agree what other tests, if any,
should be done in addition to mammograms in women with dense breasts.