Understanding Breast Changes, Part 2

by National Cancer Institute

(Page 2 of 4)

It is important to see your doctor and get a mammogram every 1 to 2 years after age 40 to find breast changes.

Here are mammograms of three different women. Doctors look at these x-rays for any breast changes that don't look normal.

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.

Calcifications

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.

Breast Changes During Your Lifetime That Are Not Cancer

You might notice different kinds of breast changes at different times in your life. Many of these are caused by changes in your hormone levels and are a normal part of getting older.

Younger women may have more glandular (more dense, less fatty) breast tissue than older women who have stopped having their period (menopause). This kind of tissue is where breast changes usually occur.

Before or during your period, you might have lumpiness, tenderness, and pain in your breasts. The lumpiness and pain usually go away by the end of your period.

During pregnancy, your breasts may feel lumpy, as the glands that produce milk increase in number and get larger. Still, breast cancer has been found in pregnant women, so talk with your doctor if you have questions about any breast lumps.

While breastfeeding, you may get an infection called mastitis that happens when a milk duct becomes blocked. Mastitis causes the breast to look red and feel lumpy, warm, and tender. Mastitis is often treated with antibiotics. Sometimes the duct may need to be drained. If the redness or mastitis does not go away with treatment, call your doctor, as you may need further care.

As you approach menopause, your periods may become less frequent. Changing hormone levels also can make your breasts:

• Feel tender, even when you are not having your period
• Feel more dense
• Feel more "lumpy" than they did before

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