What Shading May (or May Not) Indicate
Regular mammograms are an important part of breast health.
Amammogramimage has a black background and shows the breast in variations of gray and white.
In general, the denser the tissue, the whiter it appears.
National Cancer Institute
Fat and other less-dense tissue look gray on a mammogram image.
Mammograms look different for each person: What matters most is what’s normal for you.
Read on to see some images of what mammograms may look like, and what reports you might read.
National Cancer Institute
Women with breast cancer risk factors may start screening earlier.
Over time, a woman’s breasts can change.
This can happen after childbirth, following abreast biopsy, or with breast implants.
National Cancer Institute
It is not uncommon to getbenign lumps, cysts, masses, calcifications, or denser tissue.
Normal Dense Breast Tissue
This image shows two mammograms of normal, dense breasts.
Young women, especially those who have not had children, usually have dense and rather firm breast tissue.
National Cancer Institute
If a particular area needs a better image, abreast ultrasoundis usually the next step.
Dense breasts are identified as such based on their appearance on a mammogramnot what they feel like.
Having dense breasts is not abnormal.
ksass / Getty Images
It just means you have less fat in your breasts than is typical.
However, women with dense breasts do have a slightly higher risk of developing breast cancer.
Calcifications are associated with extra cell activity in breast tissue.
Pam Stephan
Usually, the extra cell growth is not cancerous.
The pattern and shape of microcalcifications can also give radiologists clues about whether cancer may be present.
In this mammogram image, the breast calcifications are in ductal patterns.
National Cancer Institute
This is considered an abnormal mammogram, but it’s not necessarily one that indicates cancer.
In this case, the woman was advised to have a follow-up mammogram in three months for comparison.
If the woman had a lump associated with these calcifications, immediate further testing would have been needed.
Fibrocystic Breast Tissue
Fibroadenomasandcystsare benign breast masses that can appear in fibrocystic breast tissue.
These can occur alone or in groups and show up on mammograms as a dense (white) mass.
This mammogram highlights thickened areas that are typical offibrocystic changes.
it’s possible for you to also identify some ducts by the patterns they form.
Normal fibrocystic changes in the breast can be affected by monthly hormonal fluctuations that may taper off in menopause.
About half of all women experience fibrocystic changes in their breasts, especially during their fertile years.
Fibrocystic changes in the breast are usually not a sign of disease and do not require treatment.
These changes can sometimes causebreast painand lumpiness, so if this becomes concerning, see your healthcare provider.
The tumor may invade surrounding tissue, or it may shed cells into the bloodstream or lymph system.
Likewise, a mammogram may appear normal even if cancer is present.
This woman had been successfully treated for a punch in of breast cancer calledinvasive ductal carcinoma.
Inboth viewsof this breast reconstruction, the implant appears as a light, smooth-sided area.
This implant is inserted into a pocket of the chest wall.
The chest wall muscle appears as the medium-dark area just outside the implant.
Mammograms taken after a diagnosis of breast cancer are important screening tests.
There is no evidence of breast cancer in these images.
Having these two views is very helpful for healthcare providers to determine breast health.
If you are unsure of what any findings mean, talk to your healthcare provider.
In addition to noting any findings, you will see aBI-RADSnumber.
If you have not had a biopsy, you will be assigned a number between 0 and 5.
A score of 0 indicates that the mammogram didn’t provide enough information to make a clear call.
A score of 6 is given when a mass has already been found malignant.
Breast MRI is much more expensive than mammograms, and the equipment is not as widely available.
For this reason, MRI technology is not used for routine breast screening.
However, breast MRI has its place.
These two side-by-side comparisons show mammography on the left and an MRI on the right.
The MRI image illustrates the deeper level of detail, which is extremely helpful to confirm a diagnosis.
In general, dense tissue shows up white, and less dense tissue is grayer.
American Cancer Society.Breast density and your mammogram report.
Cleveland Clinic.Benign breast disease: Lump in the breast.
2020;2(2):1-4.
American Cancer Society.Limitations of mammograms.
U.S. Food and Drug Administration.Important Information: Final Rule to Amend the Mammography Quality Standards Act (MQSA).
American Cancer Society 2017.What Does a Doctor Look for on a Mammogram?
2017;24(4):579-584. doi:10.1007/s12282-016-0742-z
