According to the National Cancer Institute, a woman has about a 1 in 8 chance of developing breast cancer in her lifetime. Routine mammography is the standard of care for early detection of breast cancer. If specific features, such as calcifications or masses are identified in a routine mammogram, or if significant differences with previous studies are identified, the mammogram result may be classified as abnormal. An abnormal result does not necessarily mean that cancer has been found, however, additional testing is recommended to identify the nature of the abnormality.
Breast Calcifications
Calcifications are small deposits of calcium that show up as white specks on a mammogram. Large calcifications occur in about half of women over 50, and are not generally associated with cancerous conditions.
When calcifications consist of smaller specks, either in clusters or in isolation, there is more concern. This type of finding may be classified as abnormal, and the radiologist may wish to examine the calcifications more closely with a diagnostic mammogram and biopsy in order to determine if they might be related to a cancerous condition.
Masses in the Breast
Mammograms can identify masses in the breast that are too small to feel. Most masses identified on a mammogram are cysts or one of several types of benign solid tumor such as a fibroadenoma. A cyst is a fluid-filled sac generally found in the glandular tissue of the breast.
The presence of cysts in the breast is not usually a cause for concern, as they are not associated with an increased risk of breast cancer.
Solid masses can be caused by a variety of underlying conditions, most of which are benign in nature. In general, masses with irregular or poorly defined borders are more likely to be cancerous than those with smooth, well defined borders. A biopsy may requested if a previously identified mass changes over time or if a new mass is identified.
Diagnostic Mammograms
During a diagnostic mammogram, special enlarged images are made of specific areas of concern such as a cluster of calcifications. Based on these detailed images, the radiologist can either make a diagnosis or recommend further testing such as a biopsy.
Breast Sonogram
During a sonogram, soundwaves are used to visualize the internal structure of the breast. It may be conducted along with a diagnostic mammogram to further clarify the suspicious features. Sonography is particularly useful in determining if a mass seen on a mammogram is a cyst.
Breast Biopsy
If calcifications still look suspicious after closer examination, or an identified mass is found to be solid, a biopsy will often be recommended. During a biopsy, a surgeon removes a sample of tissue from the area of interest and then examines the tissue under a microscope. This is the best and most certain way to determine if cancer is or is not present.
A recommendation of a biopsy does not mean that a diagnosis of cancer is certain. In fact, approximately 80 percent of biopsies are found to be benign.
