I Need a Mammogram, but What Type?

A screening mammogram is an X-ray examination of the breast designed to identify the presence of breast cancer in individuals who do not exhibit any warning signs or symptoms, even when the cancer is too small to be detected by touch. Screening mammograms represent the most effective method for detecting breast cancer in most women and are the only tests demonstrated to reduce mortality rates associated with breast cancer.

Talk to your doctor about when and how often to get a screening mammogram. Erlanger offers specific guidelines based on your age, risk factors, and other considerations. 

If you've found an issue with your breast, it is important to remain calm, as the majority of lumps don’t indicate cancer. In younger women, these lumps are frequently associated with menstrual cycles and typically resolve by the end of the period. However, any lump or alterations in the breast may signal the presence of breast cancer, and it is advisable to consult a physician if you observe any of the following changes:

• A lump, hard knot, or thickening in the breast or underarm area;
• Swelling, warmth, redness, or darkening of the breast;
• Alterations in the size or shape of the breast;
• Dimpling or puckering of the skin; an itchy, scaly sore, or rash on the nipple;
• Retraction of the nipple or other breast areas;
• Sudden nipple discharge; or persistent pain in a specific area.

If you or your partner notice a change or lump in your breast, or if a change is discovered during a clinical exam or a screening mammogram, the next step is to undergo a diagnostic mammogram.

• A diagnostic mammogram is similar to a screening one, but it involves taking additional images to closely examine the area of concern. Despite its name, a diagnostic mammogram cannot definitively diagnose breast cancer; it can only indicate whether the abnormality appears to be cancerous.
• A breast ultrasound employs sound waves to create images of the breast, helping to differentiate between a fluid-filled cyst and a solid mass, which may or may not be cancerous. However, a breast ultrasound is not effective as a standalone screening test.
• A breast MRI may also be recommended in certain situations as a follow-up to investigate any abnormal findings further.

If a follow-up test indicates the possibility of breast cancer, a biopsy is performed. This procedure involves removing cells or tissue for examination to determine the presence of cancer.

While a biopsy is essential for diagnosing or confirming breast cancer, it does not itself diagnose the disease but can help eliminate it as a possibility. If a diagnostic mammogram does not rule out cancer, additional imaging tests may be conducted. Should the results point towards breast cancer, a biopsy will be necessary to either confirm or dismiss the diagnosis.

It's important to note that a lump or change in the breast could be due to benign conditions, which are non-cancerous issues affecting the breast. Some of these benign conditions may cause pain or discomfort and might require treatment, while others do not. Since some benign conditions can resemble breast cancer, further testing is essential to clarify the situation.

As women age, they may develop small deposits of calcium, known as calcifications, in their breasts. These deposits are typically too minute to be detected through touch but can appear as small, bright white spots on a mammogram.

In most cases, calcifications are benign; however, specific patterns, such as tight clusters or linear formations, may raise concerns and warrant further investigation, as they could indicate the presence of breast cancer.

Calcifications are particularly prevalent among women over the age of 50 and may be associated with factors such as advancing age, previous injuries, or breast infections like mastitis. Additionally, for women who have undergone treatment for breast cancer, these calcifications may be linked to prior surgeries or radiation therapy.

This can also so be connected to the quantity of calcium in a woman’s diet.