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Mammography: Diagnostic Breast Mammograms

All women should perform a breast self-exam (BSE) on a monthly basis in order to ensure that no lumps have developed in their breasts, and that no change in the shape or texture of their breasts has occurred. Women over age 40, and women who are not considered high risk for breast cancer, should get a screening mammogram every 1-2 years. Women, who have a previous history of breast cancer, or a family history of breast cancer, are considered high risk and should be screened younger than age 40, and screened more frequently.

Diagnostic Breast MammogramA screening mammogram can detect lumps or tumors that are typically not felt by a breast self- exam (BSE). It can also find tiny calcium deposits that, in some cases, are indicative of cancer.

A diagnostic breast mammogram checks for signs of cancer when a lump or other symptom has been discovered on a screening mammogram, but does not determine if a lump is benign or malignant. This type of mammogram can better identify breast changes initially found on a screening mammogram. It views more clearly breast tissue that is difficult to see on a screening mammogram due to the fact that different angles can be adopted and images are magnified.

The diagnostic breast mammogram can store the image directly on film or directly on a computer (digital); both use x-ray radiation to produce the image. Research has not shown that digital images are better at showing cancer than x-ray film images. However, digital imaging has the following advantages:

  • Ease of image sharing by computer with other doctors
  • The difference between normal and abnormal tissues may be easier to detect
  • Fewer follow-up tests
  • Fewer repeat images means less exposure to radiation

A breast ultrasound detects changes that are felt, but not visible on a mammogram. It helps differentiate between fluid filled cysts and solid masses. There is no exposure to radiation during this procedure. An ultrasound uses high frequency sound waves that translate into a picture displayed on a computer screen. There is no positive determination as to whether or not a suspected mass is cancer.

When breast cancer is suspected, an MRI (magnetic resonance imaging) is effective in providing a further look. This equipment can show if the lymph glands are enlarged, indicate if they contain cancer and provide a clue to the stage of cancer. A breast tumor that did not show up on a mammogram can show up on an MRI. An MRI can help guide a biopsy needle into tumors not seen on mammograms; the process is known as ‘MRI- guided biopsy’.

The Ultimate Diagnostic Tool
Even though the diagnostic breast mammogram can discover a suspicious area, it cannot determine the presence of cancer. Only a biopsy can determine if a tumor is positive or negative for cancer cells. A biopsy procedure entails removing cells from a tumor with a needle or scapula, and examining them under a microscope.

Signs of breast cancer include pain, thickening of skin on the breast, a change in breast shape or size, or nipple discharge. Mammograms are but one tool in the wide spectrum of tests available for the definitive diagnosis of breast cancer. Ongoing research in early breast cancer detection is saving millions of lives.