Mammogram abnormalities
Diagnostic mammograms
Increasing numbers of women are now having mammograms - low-dose X-rays of the breast. A mammogram may be done as part of the investigation of a breast problem, such as a breast lump, pain, skin change or nipple discharge. In these circumstances the test is known as a diagnostic mammogram.
Screening mammograms
Mammograms are also performed on women with no apparent breast problems as a way of detecting breast cancer in its early stages, when treatment is most likely to be successful. This is called a screening mammogram.
The mammogram screening program, BreastScreen, has been running in Australia since 1991. It has successfully reduced deaths from breast cancer in women aged 50–69 years by around 21–28 per cent.
Causes of an abnormal mammogram
Being told that your screening mammogram is abnormal can understandably be a worrying experience. But it is important to remember that most abnormal mammograms do not mean breast cancer.
A number of things other than cancer can produce an abnormality on your mammogram.
- Shadows - these can due to increased density of breast tissue or harmless cysts.
- Calcium deposits (calcification) - although large numbers of tiny calcium deposits may be associated with cancer, calcification can also be caused by ageing, injury or a benign (harmless) lump such as a fibroadenoma ('breast mouse').
- Scarring - this might be due to previous breast surgery.
Tests after an abnormal mammogram
If your mammogram is abnormal, further tests will be necessary to determine the exact cause of the abnormality.
You may need to have further mammograms, looking more closely at the site of the abnormality. Sometimes an ultrasound is needed. This painless test can help tell if cysts are present.
Samples of breast tissue may be needed for examination under the microscope. These samples are obtained in a variety of ways.
- Fine needle aspiration - cells are obtained through a narrow needle attached to a syringe.
- Core biopsy - a small sample of tissue is removed with a needle, usually under local anaesthetic. The biopsy may be guided by an X-ray or ultrasound.
- Surgical biopsy - the suspicious area is sampled or removed in an operation. This is usually under general anaesthetic. A thin wire may be inserted under X-ray control immediately before the biopsy to indicate the abnormal area. The surgeon will then be able to locate the wire and be sure of sampling the correct area.
All these procedures are relatively painless and are aimed at eliminating the possibility of breast cancer. If you are found to have breast cancer its early detection and removal greatly increase your chance of a complete recovery.
Last Reviewed: 21 July 2010
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