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Understanding Breast Cancer and Mammograms

What if the radiologist sees something suspicious on your mammogram?

The fear this scenario evokes is real, but facts may help calm it. Most abnormalities on a mammogram are not breast cancer.

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On a screening mammogram, questionable abnormalities sometimes require additional evaluation. With further examination (imaging studies and biopsy), most of these abnormalities are found to be benign (non-cancerous).

What Is a Screening Mammogram?

A screening mammogram is used to detect cancers before symptoms develop. In a screening mammogram, each breast is flattened and X-rayed in two different positions: from top to bottom and from side to side. When a mammogram image is viewed, dense breast tissue often found in younger women appears white and opaque compared to fatty tissue often found in older women. the fatty tissue appears darker and more translucent. Those who have dense breasts may have abnormalities that are not easily visualized.

Several expert groups, including the American Cancer Society, recommend yearly screening mammograms starting at age 40. However, there is controversy on whether every woman needs a screening mammogram at 40 since the chance of having breast cancer is lower for those younger than age 50. As a result, other groups such as the U.S. Preventive Services Task Force (USPSTF) recommend screening at age 50. Generally, screening mammograms are recommended every 1-2 years depending on your risk. Most experts recommend continuing screening mammograms until a woman is in her mid-70s, especially if she is in otherwise good health and has a life expectancy of 10 or more years.

When to get a mammogram is a personal decision between you and your doctor. If you're over 40, talk to you doctor about when you should begin mammogram screening. If you have close family members who developed breast cancer at an early age, you may need to consider screening at a younger age.

What if Something Looks Abnormal?

Potential abnormalities are found in up to 8% of women who have screening mammograms. This small group of women needs further evaluation that may include diagnostic mammography, breast ultrasound, or needle biopsy. Of those women asked to return for further testing, 10% will have breast cancer.

After the additional evaluation is complete, most of these women will be found to have nothing wrong.

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