Mammograms are an essential tool for detecting breast cancer, but there’s more to the process than taking images. Dr. Ashley Grindol, breast imaging radiologist at Woman’s Hospital, explains how radiologists interpret mammograms, what factors can affect results, and why you might be called back for additional imaging.
What do breast imaging radiologists do?
Breast imaging radiologists use mammograms, ultrasounds, and MRIs to evaluate breast tissue and look for areas that may need further attention. One way they do this is by comparing your current breast images with previous ones to see if anything is new, such as calcifications, masses, or asymmetries. By identifying subtle changes between exams, they can detect potential breast cancers at their earliest stages, sometimes before symptoms even develop.
In addition, breast imaging radiologists work closely with surgeons, oncologists, and pathologists to help create a treatment plan best suited for you if breast cancer is present.
How often should I get a mammogram?
Mammograms are the primary screening tool used to detect breast cancer in women without symptoms. They can reveal changes that may be too small to feel and are the only breast cancer screening method proven to lower overall breast cancer deaths. This is because mammograms typically find breast cancer at an earlier stage when more treatment options are available.
“A mammogram won’t change [whether or not you have cancer],” notes Dr. Grindol, “but it will catch it at an earlier stage where the treatment is more effective and less intensive, you’re much more likely to be cured, and you’re going to be around a lot longer.”
Screening recommendations vary depending on the organization, your age, and your individual risk factors. In general, the American Cancer Society recommends that women should begin getting annual mammograms at age 40. Women who have a family history of breast cancer, dense breast tissue, or the BRCA1 or BRAC2 gene mutation might want to begin screening earlier or receive additional imaging.
Annual mammograms are important, but don’t feel discouraged if it’s been two or three years since your last mammogram. It’s never too late to schedule your screening and get back on track.
What affects mammogram results?
Several factors can affect how breast tissue appears on a mammogram and how easily a radiologist can interpret the findings. These include:
Breast density
Breast density refers to the composition of your breast, which is made up of a mixture of fat and fibro-glandular tissue. Breasts with more tissue than fat are considered dense.
On a mammogram image, fat appears dark while tissue appears white. Because many abnormalities also look white, it might be harder to spot a mass if it’s mixed in with the tissue. Dense breasts can therefore make mammograms more difficult to interpret, so you’re more likely to get called back for additional imaging.
Changes in weight and hormones
Changes in weight can affect how the breasts appear on a mammogram. For example, weight gain or loss may change the proportion of fatty tissue in your breasts. Hormonal changes, including those associated with menopause or hormone therapy, can also affect breast density.
These changes don’t necessarily mean there’s a problem, but it’s always a good idea to tell your healthcare provider about any recent changes in your health.
Breast implants
Breast implants can make it harder to see all of the breast tissue on a mammogram, especially if they’re placed in front of your chest muscle. Radiologists need to use additional techniques to move the implant out of the way to capture as much breast tissue as possible.
If you have implants, let the imaging facility know when scheduling your appointment so the team can properly prepare for your exam.
Why did I get a callback?
Being called back after a mammogram can be unsettling, but it doesn’t automatically mean you have breast cancer. In fact, callbacks are a fairly common part of the breast imaging process. A callback simply means your radiologist needs more information to better assess a certain area. This may involve taking additional mammogram images, performing a breast ultrasound, or recommending another type of evaluation. In many cases, the additional images help clarify a finding that turns out to be benign.
Some reasons you may be called back include:
- Calcifications – These tiny calcium deposits are common and usually benign, but certain patterns or changes in their appearance may require closer evaluation.
- Asymmetries – These are areas of breast tissue that look different from the surrounding tissue or the corresponding area of the other breast. Asymmetries can happen for many reasons, including slight differences in how the breast was positioned during the mammogram or changes in breast tissue related to weight loss/gain or hormones. Further imaging can help determine if an area needs further evaluation.
- Dense breast tissue – Dense tissue can overlap with other structures, making it more difficult to see abnormalities. Additional images may help radiologists analyze areas that are unclear on a mammogram.
If you receive a callback, try to remember that it’s a step toward getting a clearer picture of your breast health; it’s not a diagnosis of cancer.
Make your breast health a priority
Breast imaging has come a long way, making earlier detection and more personalized screening possible for more women every day. Although a mammogram may take only a few minutes, it remains one of the most important tools for finding breast cancer early, when it’s often most treatable.
Whether you’re scheduling your first mammogram or getting back on track after a few years, it’s never too late to prioritize your screening. Talk with your OB/GYN about your breast cancer risk and a screening schedule that’s right for you.