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When you undergo a mammogram or other breast imaging, you may be curious as to what the radiologist is looking for in your images. Many benign conditions can show up on a mammogram. If a mass is detected in your breast, several indicators can help the radiologist to determine its nature. Remember that the vast majority of potentially suspicious things that show up on a mammogram are actually benign. Although approximately 10% of women receive callbacks for further evaluation after a mammogram, only 0.2%-0.4% of follow-up procedures result in cancer diagnoses. If you are called back, your radiologist will use diagnostic imaging to look more closely at the characteristics of what appeared on your mammogram.[1]
Is it solid or cystic?
Simple cysts are fluid-filled sacs common in women between the ages of 30 and 50.[2] Although they look abnormal on a mammogram, simple cysts are non-cancerous. Ultrasound imaging is often used to determine whether a mass is a simple (completely fluid-filled) cyst, a complex cyst (partially solid), or a solid mass. Simple cysts do not require biopsy, but complex cysts are more of concern and may need to be biopsied to determine whether cancer is present.[3]
What is its shape?
Looking at the margins of a mass in the breast can provide valuable information about what type of mass it is. A breast carcinoma typically appears to have fingers or points on its surface. It can also appear round with indistinct borders, which may make it difficult to differentiate from abscess, hematoma, focal fibrosis, or lymphoma on a mammogram.[4] Other indicators are necessary to determine the nature of a round mass.
Are calcifications present?
Calcifications commonly appear on mammograms and are usually benign. If they appear as clusters of tiny, sand-like particles, however, this can be a sign of breast cancer. Ductal carcinoma in situ (DCIS) is a non-invasive form of breast cancer that typically appears in this way. If your radiologist observes this clustered pattern of calcifications on your mammogram, additional follow-up will be ordered.[5]
What is the density of the mass?
Studies have shown that the density of a mass can help to determine the likelihood of malignancy. Higher-density masses have a greater chance of being malignant than lower-density masses.[6]
Does imaging show increased blood supply to the mass?
Cancer requires a higher blood supply than non-cancerous growths.[7] Ultrasound or MRI may be used to determine blood supply to the suspicious area.
The professionals at Iowa Radiology are dedicated to providing you the best possible care. We encourage questions and are available to speak with you about your procedure, follow-up, and results.
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Sources
[1] http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs-mammograms
[2] http://breast-cancer.ca/screening/mass-characteristics-followup.htm
[3] http://www.cancer.org/treatment/understandingyourdiagnosis/examsandtestdescriptions/mammogramsandotherbreastimagingprocedures/mammograms-and-other-breast-imaging-procedures-what-does-doc-look-for
[4] https://www.inkling.com/read/fundamentals-diagnostic-radiology-brant-helms-4th/chapter-20/analyzing-the-mammogram
[5] http://ww5.komen.org/BreastCancer/Mammography.html
[6] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3029888/
[7] http://www.medicinenet.com/breast_lumps_in_women/page4.htm
