Findings on a Mammogram and Mammogram Results

For women who use menopausal hormone therapy (MHT), breast density may not decrease until they stop using MHT. MHT is also called postmenopausal hormone therapy and hormone replacement therapy (HRT).

Women with dense breasts (as seen on a mammogram) have a somewhat higher risk of breast cancer than women with fatty breasts [26-27].

Some, but not all, radiologists may divide this category further into 4A, 4B and 4C based on how suspicious the findings are for cancer (4A look the least like cancer).

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Mammogram images: Normal, abnormal, and breast cancer

6: Known biopsy-proven malignancy – appropriate action should be taken

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Ductal carcinoma in situ (DCIS)

Invasive breast cancer can look like a white patch or mass on a mammogram.

What this means

Adapted from American College of Radiology’s BI-RADS ® – Mammography, Fifth Edition, 2013 and American Cancer Society materials [32-33] with permission of the American College of Radiology.

Findings on a Mammogram and Mammogram Results

Young women, especially those who have not had children, usually have dense and rather firm breast tissue. Mammogram images like these can be difficult for a radiologist to read because there is less differentiation between normal and possibly abnormal tissue, potentially hiding areas that need closer study.

BI-RADS ® category

Calcifications are common, especially after age 50 [31]. They may be related to past injury to the breast or mastitis (an infection in the breast) [31].

a A simple breast cyst [75]. b Breast ultrasound, showing a cancer …

Mammography equipment can be adjusted to image dense breasts, but that may not be enough to solve the problem. If a particular area needs a better image, a breast ultrasound is usually the next step. A breast MRI (magnetic resonance imaging) may be recommended for young women with a strong family history of breast cancer or those known to have genetic mutations that increase risk (see below).

Assessment is complete

Most calcifications are benign (not cancer). However, certain patterns of calcifications are suspicious and need more testing. Tight clusters or lines of tiny calcifications (microcalcifications) can be a sign of breast cancer.

Normal and Abnormal Mammogram Images

Breast Cancer, X-Ray

Images used with permission of the American College of Radiology (www.acr.org).

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Dense breast tissue

Breast density may decrease after menopause in both women who go through natural menopause and younger women who are in menopause after surgery to remove the ovaries (oophorectomy).

No evidence of cancer on the mammogram.

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