What is a mammogram?
A mammogram is an X-ray examination of the breast used to look for signs of breast cancer and other abnormalities. It is the main imaging test used for breast cancer screening because it can detect certain findings, especially calcifications, before they can be felt.
Mammograms can also identify masses, asymmetries, and areas of architectural distortion. Although no test is perfect, mammography remains the foundation of breast imaging and has played a major role in the early detection of breast cancer.
2D mammography vs 3D mammography (tomosynthesis)
2D mammography creates standard flat X-ray images of the breast. 3D mammography, also called tomosynthesis, acquires multiple low-dose images from different angles and reconstructs them into thin slices through the breast.
2D Mammography
- Standard flat X-ray images
- Two views per breast
- Widely available
- Effective for most patients
- Overlapping tissue can obscure findings
3D Mammography (Tomosynthesis)
- Multiple images reconstructed into thin slices
- Tissue evaluated layer by layer
- Reduces effect of overlapping tissue
- Improves cancer detection in many patients
- Can lower callback rates
This allows radiologists to evaluate breast tissue layer by layer, which can make abnormalities easier to see and can reduce the effect of overlapping tissue. In many patients, 3D mammography improves cancer detection and lowers the chance of being called back for additional imaging.
Screening vs diagnostic mammogram - what is the difference?
A screening mammogram is performed when there are no current breast symptoms or known abnormalities. Its purpose is to look for early signs of breast cancer before a problem is noticed.
A diagnostic mammogram is performed when there is a specific concern, such as a lump, nipple discharge, focal pain, or an abnormality seen on a screening mammogram. Diagnostic imaging often includes additional mammographic views and may also include targeted ultrasound.
In simple terms, screening mammograms are routine preventive studies, while diagnostic mammograms are more focused evaluations of a particular issue.
What does a mammogram report include?
A mammogram report usually describes the type of mammogram performed, the patient's breast density, whether any findings are present such as masses, calcifications, asymmetries, or architectural distortion, the radiologist's overall assessment, and the recommended next step.
Most mammogram reports also include a BI-RADS category, which is a standardized system used to summarize how suspicious a finding is and what follow-up is recommended.
What does it mean to be called back after a mammogram?
Being called back after a screening mammogram means that the radiologist needs additional imaging before giving a final interpretation. This is common and does not automatically mean cancer is present.
Many callbacks happen because an area of breast tissue looked unclear on the initial images, often due to overlapping normal tissue. Additional mammographic views and sometimes ultrasound are used to clarify the finding.
Most callbacks do not result in a cancer diagnosis, but they are important because they allow the radiologist to evaluate a finding more carefully.
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