What does the doctor look for in a mammogram?

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When reviewing a mammogram, a radiologist looks for positioning of the breast, as well as masses, densities, distortions and more, says Thelma Reeves, Director of Women's Diagnostics at West Hills Hospital & Medical Center. Learn more in this video.
Sonia M. Ceballos, MD
OBGYN (Obstetrics & Gynecology)
During a mammogram, doctors are looking for signs of breast cancer and measuring breast density, says Sonia Ceballos, MD, of MountainView Hospital. Watch this video to learn more.
Jennifer Rollenhagen, MD
Diagnostic Radiology
In a mammogram screening, doctors look for particular markers that indicate abnormality in the breast tissue. In this video, radiologist Jennifer Rollenhagen, MD, of Mercy Health, explains what doctors are looking for in a mammogram.

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The doctor reading the mammogram films 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. Macrocalcifications are found in about half the women over 50, and in about 1 of 10 women under 50.
  • 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 that 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 mammograms. 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. Masses that are not cysts usually need to be biopsied.
  • 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 be helpful to 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.
 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.