Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
If the mammogram appears clearly normal, no further tests are needed. Most breast changes are not malignant, and most women will have no breast cancer detected during a regular mammogram screening.
Sometimes the radiologist will request an additional mammogram or an ultrasound study of the breast, which never is a substitute for, but always complements, the views taken with a mammogram.
Sometimes a woman could be recalled after a few days because the radiologist simply wants to be sure the breast images are the best possible and for a better evaluation of certain areas of the breast. In such cases, special mammographic tests may be performed.
If cancer is found, a number of treatment options, including surgery, radiotherapy, hormone treatment, and chemotherapy are available. The treatment option must be based on the individual woman and the type and size of breast cancer present.
What mammograms may show
Any suspicious area on a mammogram will be magnified and examined. The radiologist reading the mammogram will consider all views taken. Generally, if the radiologist can see defined margins in a suspicious area, they may indicate a benign or harmless lesion. If they are undefined, the mammogram may indicate a malignant or cancerous lesion. Obviously, the experience of the physician who sees the mammogram is fundamental in order to distinguish the benign lesions from the malignant ones.
A mammogram could show white spots called, according to their size, calcifications, and microcalcifications. The first are small deposits of calcium salts that occur in the breasts for many reasons. The second are very tiny and can be scattered throughout the breasts or gathered in small clusters and are normally due to aging or noncancerous causes (for example, from aging of the breast arteries, old injuries, or inflammations). Most of them are of no concern.
Suspicious microcalcifications must be evaluated further, and the doctor will consider their number, size, and where they are located, among other characteristics. Sometimes calcifications can indicate the presence of early breast cancer, but usually they just indicate the presence of tiny cysts.
If some microcalcifications are present on a mammogram, the woman may be asked to return for further assessment and use of special
X-rays, which magnify the concerned area of the breast.