Your mammogram, explained
Even when you hear that your annual mammogram is normal, it can be disconcerting to get your hands on the actual report, filled with mysterious, scary terminology. Yes, these reports are meant for communication between doctors, but most of us, if we don’t know what a word means or it sounds bad, think it must be bad…really bad.
The word “negative” is a good example. In life, negative things are bad. In medicine, “negative” means nothing bad was found. (But even after you’ve gotten a negative report, if you feel something in your breast that wasn’t there before, get it checked out.)
Interpreting your mammogram should be left up to the radiologist, but it’s still helpful to know what common phrases mean. Keep in mind that these terms are descriptive, not diagnostic: A biopsy is the only way to diagnose breast cancer.
SEVEN TERMS AND WHAT THEY MEAN
DENSITY: The amount of fibrous and glandular tissue, as opposed to fatty tissue, in your breasts. The less fat there is, the higher the density. Having dense breast tissue is common and not abnormal, but this can make it harder to evaluate mammogram results and may be associated with increased risk of breast cancer. Women with dense breasts may also need an ultrasound or an MRI.
This finding may be due to imperfect positioning during the scan, or maybe your breasts, like most women’s, don’t match. When a woman is “invited” back for more views, it’s often because an area on one breast didn’t look the same as the corresponding area on the other.
No mass was seen, but the appearance of the breast tissue is not normal. The radiologist’s level of concern will depend on what is contributing to the distortion.
Calcium deposits appear as bright white spots on a scan. Most calcifications are not worrisome and do not indicate cancer.
Small clusters of calcium deposits are concerning, but while they often indicate that a biopsy is needed (intraductal calcifications generally require a biopsy), they’re not diagnostic of breast cancer.
These words, while terrifying, are also not a diagnosis of cancer. A mass is a growth—period. (A bunion is a mass, but not toe cancer.) A fibroadenoma is an example of a common benign (noncancerous) fibrous tumor. A calcified mass is almost always benign. But of course, some masses are of greater concern than others.
SPICULATED FOCAL MASS:
Up to 80% (but not 100%) of these masses are cancerous. A biopsy of these is essential. If you see this on a report, you have reason to be concerned, but be glad you had the mammogram, since most of these masses can’t be felt during a breast exam. If a biopsy does detect cancer, early detection and removal is the surest way to a cure.
Based on all these findings, the radiologist will use the standardized Breast Imaging Reporting and Data System to communicate an overall impression to your doctor, indicating a level of concern and suggested next steps, if any.
Dr. Streicher is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine.