January 01, 2007

Finding Breast Changes


There are two ways to find breast changes:
1. Clinical breast exams--a breast exam done by your health care provider
2. Mammograms --an x-ray of your breasts

One way to find breast changes is with a clinical breast exam done by your health care provider. He or she will check your breasts and underarms for any lumps, nipple discharge, or other possible changes. This breast exam should be part of a routine medical check-up.
The best tool for finding breast cancer is a mammogram. A mammogram is a picture of the breast that is made by using low-dose x-rays. It is currently recommended that women over age 40 receive a mammogram every 1 to 2 years.

Some women check their own breasts for changes. If you find a change, it's important to call your health care provider for an appointment. Make sure to watch the change you found until you see your provider. But a breast self-exam and a clinical breast exam are not substitutes for mammograms.

Questions to ask your health care provider about a breast change
How can I tell the difference between my usual lumps and lumps I need to do something about?
How will you be able to tell what kind of breast change I have?
What should we do to watch this change over time?

Mammograms are used for both screening and diagnosis.
A screening mammogram is used to find breast changes in women who have no signs of breast cancer. Most women get two x-rays of each breast.

If your recent screening mammogram revealed a breast change since your last one, or if you or your health care provider noticed a change, he or she will probably recommend a diagnostic mammogram. More x-rays are taken during a diagnostic mammogram than a screening mammogram to get clearer, more detailed pictures of the breast. It is also used to rule out other breast problems.

Take your original mammogram and copy of the medical report with
you if you change doctors or centers or need a second opinion.

A digital mammogram is another way to take a picture of your breasts. The procedure for having a digital mammogram is the same as a screening mammogram, except that it records the x-ray images in computer code instead of on x-ray film. It is important to see your doctor and get a mammogram every 1 to 2 years after age 40 to find breast changes.

Mammograms and Breast Implants

When you go for your mammogram, tell staff if you have a breast implant. A technologist who is trained in x-raying patients with implants will do your mammogram. Breast implants can hide some breast tissue and make it harder to read your mammograms.

If you got implants for cosmetic reasons:
You still need to get screening mammograms, with extra pictures to help get an accurate reading.

If you got an implant after having a mastectomy for breast cancer:
You should continue to get mammograms of your other breast. Ask your doctor if you still need mammograms of the breast with the implant.

Getting Your Mammogram Results

Ask your doctor when you will get your results. You should get a written report of your mammogram results within 30 days of getting the x-ray. This is the law. Be sure the mammogram facility has your current address.
If your results were normal, it means the radiologist did not find anything that needs follow-up.
If your results were abnormal, it means the radiologist found:
A change from a past mammogram
A change that needs more follow-up

What a Mammogram Can Show
The radiologist will look at your x-rays for breast changes that do not look normal. The doctor will look for differences between your breasts. He or she will compare your past mammograms with your most recent one to check for changes. The doctor will also look for lumps and calcifications.

Lumps (or "mass")
The size, shape, and edges of a lump sometimes can give doctors more information about whether or not it is cancer. On a mammogram, a growth that is benign often looks smooth and round with a clear, defined edge. On the other hand, breast cancer often has a jagged outline and an irregular shape.

A calcification is a deposit of the mineral calcium in the breast tissue. Calcifications appear as small white spots on a mammogram. There are two types:

Macrocalcifications are large calcium deposits often caused by aging. These are usually not cancer.

Microcalcifications are tiny specks of calcium that may be found in an area of rapidly dividing cells. If they are found grouped together in a certain way, it may be a sign of cancer.

Depending on how many calcium specks you have, how big they are, and what they look like, your doctor may suggest that you:
Have a different type of mammogram that allows the radiologist to have a closer look at the area
Have another screening mammogram, usually within 6 months
Have a test called a biopsy.

Are Mammogram Results Always Right?
No. Although they are not perfect, mammograms are the best method to find breast changes. If your mammogram shows a breast change, sometimes other tests are needed to better understand it. Even if the doctor sees something on the mammogram, it does not mean it is cancer.

Changes That Need More Follow-Up
Sometimes your doctor needs more information about a change on your mammogram. Your doctor may do follow-up tests such as an ultrasound or more mammograms. The only way to find out if an abnormal result is cancer is to do a biopsy. It is important to know that most abnormal findings are not cancer.

Adapted from National Cancer Institute