Mammography

One of the most frequently used tests to diagnose breast diseases is a mammogram. There are two types of mammograms – screening mammograms and diagnostic mammograms.

A screening mammogram is an x-ray of the breast used to detect breast changes in women who have no signs or symptoms of breast cancer. It usually involves two x-rays of each breast. Mammograms make it possible to detect many abnormalities or tumors that are too small to be detected during a breast exam.

If you have a questionable screening mammogram, or if a lump or other sign or symptom of breast cancer has been found, the provider may request a diagnostic mammogram. A diagnostic mammogram also may be used to view breast tissue in special circumstances, such as the presence of breast implants. A diagnostic mammogram takes longer than a screening mammogram because it involves more x-rays in order to obtain views of the breast from several angles. The technician may magnify a suspicious area to produce a detailed picture that can help the provider make an accurate diagnosis.

The two main types of abnormalities doctors look for on mammograms are masses and calcifications. Masses can be due to a cancer or a benign breast disease. The size, shape, and edges of a mass help providers determine whether it is likely to be a cancer.

Calcifications are tiny mineral deposits within the breast tissue that appear as small white spots on the films. Calcifications are divided into two types:

Macrocalcifications and Microcalcifications. Macrocalcifications are larger calcium deposits that are most likely changes in the breasts caused by things like aging of the breast arteries, past injuries, or inflammation. These deposits are associated with benign conditions and usually do not require a biopsy. Almost 50% of women over the age of 50 will show some macrocalcifications on their mammogram. One in ten women under the age of 50 will also show some macrocalcifications.

Microcalcifications are smaller deposits of calcium in the breast that may appear alone or in clusters. Keep in mind that an area of microcalcification  seen on a mammogram does not necessarily mean that cancer is present. The shape and pattern of microcalcifications can help the provider determine the likelihood that a cancer might exist.

In some cases, a provider may suggest a follow-up mammogram in 3 to 6 months. In other cases, the microcalcifications may look more suspicious and additional tests may be required.