An Overview of the Importance of a Mammogram & a Lump in the Breast

It is the New Year. Do you know when your next mammogram screening will be?  The skilled OBGYN physicians that make up the Women’s Specialists of Plano’s office in the Plano, Frisco and Dallas, Texas area offer the following information for those who are new to the mammogram process as well as for those who have general questions and/or concerns about a lump in the breast.

What are the National Cancer Institute’s (NCI) Recommendations for Screening Mammograms?

According to the National Cancer Institute, “Women age 40 and older should have mammograms every 1 to 2 years.
 Women who are at higher than average risk of breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.”

What is a Mammogram?

A mammogram is used to check for breast cancer in the breast. It is an x-ray image and will show if there is any sign (such as a tumor, mass, lump in the breast, etc.) of cancer as well as if the breast tissue appears normal. A mammogram can be done digitally or via film. This common mammogram procedure is also referred to as a screening mammogram where several images are taken of each breast.  The x-ray images help physicians screen for breast cancer when lumps cannot be felt externally.

When a mammogram is ordered because a woman has felt a specific lump in the breast during a routine breast examination, or because she has another symptom, then it is referred to as a diagnostic mammogram. This mammogram is helpful in order to rule out cancer; oftentimes these lumps are benign cysts or tiny deposits of calcium. A diagnostic mammogram takes longer to perform than a screening test because more images and x-rays are needed and they are typically taken at a variety of angles.  Diagnostic mammograms are also used on women where screening becomes more challenging; such as in the instance where breast implants are in place.

What are the Benefits of Screening Mammograms?

Most women will have their first screening mammogram around age 40; at this young age, early detection of breast cancer can often be seen with screening mammography alone.  For women who have a history of breast cancer in their family, or who have a history of cysts and benign lumps, and for those who have had breast augmentation, a diagnostic mammogram may be ordered from start.

Is there a Downside to a Screening Mammogram?

A screening mammogram does not necessarily mean that cancer will be found.  These mammograms can detect cancerous tumors that often cannot be felt by touch (such as a lump in the breast), but in 20% of the cases, screening mammograms will miss breast cancers that are present.

False-Negative Results vs. False-Positive Results—What Does This Mean?

False-negative mammogram results occur when cancer exists within the breast at the time of screening, but it is not caught during the screening mammogram. False-negative results occur in younger women more so than older women because younger women have higher breast density—which is the primary cause of a false-negative result.  On the other hand, older women will have more fatty tissue in the breast.  High-density breast tissue, as well as tumors, will show up as white on the x-ray, whereas fatty tissue is dark making it easier to detect a true cancer cell.

False-positive mammogram results occur when a physician or radiologist concludes that a mammogram is abnormal, even though no cancer exists.  To conclude a false-positive mammogram, further analysis will need to occur to rule out cancer. This is done usually with a diagnostic mammogram, an ultrasound or a biopsy.

Can the X-Ray Imaging from Mammograms Cause Cancer?

This is a concern for many women. Although repeated exposure to x-rays can be harmful, mammograms require just a very small dose of radiation. Exposure is low and the benefits of receiving a mammogram completely outweigh the risks of this exposure. It is very important that woman alert their health care provider if there is any possibility they are pregnant as this could be dangerous for the unborn fetus.

What is Digital Mammography?

Advances in technology have produced digital mammograms, in which the images taken are computerized and shown on a screen, rather than recorded on film using an x-ray cassette.  This allows faster and more accurate stereotactic biopsy, and reduces the patient’s discomfort, requiring her to remain still for a shorter period of time.  Digital mammography is still in its infancy, but some studies have shown that women with denser breasts, post-menopausal women, and women under the age of forty may benefit from digital mammograms.  Otherwise, the digital images are said to be “comparable” at this stage with traditional film images.

What are the Risks for Developing Breast Cancer?

According to the National Cancer Institute, women who exhibit the following traits are at an increased risk for developing breast cancer:

  • Age—as a woman ages, her chances for developing breast cancer increase
  • A personal history of breast cancer
  • A family history of breast cancer
  • Hereditary genes (For example, BRCA1, BRCA2, and others)
  • High breast density
  • Reproductive and menstrual history—Women who had their first menstrual period before age 12 or who went through menopause after age 55 are at an increased risk of developing breast cancer. Women who had their first full-term pregnancy after age 30 or who have never had a full-term pregnancy are also at increased risk of breast cancer.
  • Long-term use of hormone replacement therapy—(those who have combined estrogen and progestin hormone therapy for more than 5 years).
  • Exposure to radiation
  • Excessive use of alcohol
  • A heavy body weight/obesity
  • Lack of exercise

For additional resources on a mammogram, or to schedule an appointment to get a lump in the breast examined, please contact the physicians at Women’s Specialists of Plano, serving the communities of Plano, Frisco and Dallas, Texas.