A woman's breast has three kinds of tissue; fibrous, glandular, and fatty tissue. Having more fibrous and glandular tissue than fatty tissue means the breasts are more dense. Women with dense breasts have a higher risk of getting breast cancer. A mammogram can show you if your breasts have low or high density. Find out more about breast density.
Healthy Female Breasts Comparison - Left Young and Dense - Rt. Older and less dense
Image by TheVisualMD
What Is a Mammogram?
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Nurse examines mammogram image of patient during exam.
Image by U.S. Food and Drug Administration (FDA)
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Nurse examines mammogram image of patient during exam.
Mammograms are still the best primary tool for breast cancer screening. To continue to protect women's health, the FDA is proposing updates to the mammography regulations to reflect advances in mammography technology and processes.
Image by U.S. Food and Drug Administration (FDA)
Mammograms: What You Need to Know
A mammogram is a low-dose x-ray picture of the breast.
Why should I have one?
Mammograms can help save lives. They are still the best tool to screen for breast cancer. They can find breast lumps when they are too small for a woman or her doctor to feel. Early detection of breast cancer can help improve a woman's chance of survival.
Mammograms can not find all problems. So, every woman should work with her doctor to check her breasts. Call your doctor or clinic if you notice any change in your breasts like:
a lump
thickening
liquid leaking from the nipple or changes in how the nipple looks
How is a mammogram done?
You will need to take off your shirt and bra.
You will stand in front of the x-ray machine.
Your breast is placed on a small platform.
A clear plastic plate presses down on the breast for a few seconds. Some women say the pressure feels uncomfortable, but most don’t find it painful.
The technologist will take several pictures of the breast.
A specialist then looks at the x-ray pictures to see if there are any changes in the breast.
How do I get my results?
You and your health care provider should get written results within 30 days after your mammogram.
Call if you don’t get your results. Don’t assume that everything is normal.
Ask for your mammogram. It can be saved on a CD. Keep it to compare with mammograms you get later.
What does the FDA do?
The FDA certifies the places that give mammograms in the U.S. It’s a law called the Mammography Quality Standards Act (MQSA).
The FDA inspects the facilities and the people who work there.
How do I know if my place is certified?
The FDA keeps a list of all certified places where you can get a mammogram like a:
Digital mammograms are called 2D or 3D. Digital mammograms use a computer along with x-rays to make and show breast pictures. These pictures are taken in the same way as a regular mammogram. Ask your facility to learn more.
What else should I know before I get a mammogram?
Do not wear deodorant, perfume, lotion or powder under your arm or on your breasts on the day of your exam. It might show up on the x-ray.
Tell the clinic if you have breast implants when you make your appointment. They may need to take more pictures than a regular mammogram.
Tell the clinic if you have physical disabilities that may make it hard for you to sit up, lift your arms or dress yourself. Also, let them know if you use a wheelchair or scooter.
Talk with the staff about how they will handle issues of modesty that you may have due to your religion.
Source: FDA Consumer Health Information
Mammogram
Mammogram
Also called: Breast Cancer Screening - Mammography, Screening Mammography, Diagnostic Mammography, Mammogram
A mammogram is a low-dose x-ray picture of the breast. A mammogram is used to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.
Mammogram
Also called: Breast Cancer Screening - Mammography, Screening Mammography, Diagnostic Mammography, Mammogram
A mammogram is a low-dose x-ray picture of the breast. A mammogram is used to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.
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Use the slider below to see how your results affect your
health.
score
1
2
3
4
5
6
Your result is Inconclusive.
A BI-RADS score of 0 indicates an incomplete test. This score doesn’t mean you are cancer-free—rather, it means your doctors don’t have enough information. Additional tests and images are required to provide a final assessment.
Related conditions
A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine.
A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. It is used for women who have no breast complaints and for women who have breast symptoms, such as a change in the shape or size of a breast, a lump, nipple discharge, or pain. Breast changes occur in almost all women. In fact, most of these changes are not cancer and are called "benign," but only a doctor can know for sure. Breast changes can also happen monthly, due to your menstrual period.
Screening mammograms are done for women who have no symptoms of breast cancer. It usually involves two x-rays of each breast. Screening mammograms can detect lumps or tumors that cannot be felt. They can also find microcalcifications or tiny deposits of calcium in the breast, which sometimes mean that breast cancer is present.
Diagnostic mammograms are used to check for breast cancer after a lump or other symptom or sign of breast cancer has been found. Signs of breast cancer may include pain, thickened skin on the breast, nipple discharge, or a change in breast size or shape. This type of mammogram also can be used to find out more about breast changes found on a screening mammogram, or to view breast tissue that is hard to see on a screening mammogram. A diagnostic mammogram takes longer than a screening mammogram because it involves more x-rays in order to obtain views of the breast from several angles. The technician can magnify a problem area to make a more detailed picture, which helps the doctor make a correct diagnosis.
A digital mammogram also uses x-rays to produce an image of the breast, but instead of storing the image directly on film, the image is stored directly on a computer. This allows the recorded image to be magnified for the doctor to take a closer look. Current research has not shown that digital images are better at showing cancer than x-ray film images in general. But, women with dense breasts who are pre- or perimenopausal, or who are younger than age 50, may benefit from having a digital rather than a film mammogram. Digital mammography may offer these benefits:
Long-distance consultations with other doctors may be easier because the images can be shared by computer.
Slight differences between normal and abnormal tissues may be more easily noted.
The number of follow-up tests needed may be fewer.
Fewer repeat images may be needed, reducing exposure to radiation.
A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. Women ages 50 to 74 years should get a mammogram every 2 years. Women younger than age 50 should talk to a doctor about when to start and how often to have a mammogram.
Mammograms can not find all problems. So, every woman should work with her doctor to check her breasts. Call your doctor or clinic if you notice any change in your breasts like:
a lump
thickening
liquid leaking from the nipple or changes in how the nipple looks
You will need to take off your shirt and bra and stand in front of a special x-ray machine. The person who takes the x-rays, called a radiologic technician, places your breasts, one at a time, between an x-ray plate and a plastic plate. These plates are attached to the x-ray machine and compress the breasts to flatten them. This spreads the breast tissue out to obtain a clearer picture. You will feel pressure on your breast for a few seconds. It may cause you some discomfort; you might feel squeezed or pinched. This feeling only lasts for a few seconds, and the flatter your breast, the better the picture. Most often, two pictures are taken of each breast — one from the side and one from above. A screening mammogram takes about 20 minutes from start to finish.
First, check with the place you are having the mammogram for any special instructions you may need to follow before you go. Here are some general guidelines to follow:
If you are still having menstrual periods, try to avoid making your mammogram appointment during the week before your period. Your breasts will be less tender and swollen. The mammogram will hurt less and the picture will be better.
If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment.
Wear a shirt with shorts, pants, or a skirt. This way, you can undress from the waist up and leave your shorts, pants, or skirt on when you get your mammogram.
Don't wear any deodorant, perfume, lotion, or powder under your arms or on your breasts on the day of your mammogram appointment. These things can make shadows show up on your mammogram.
If you have had mammograms at another facility, have those x-ray films sent to the new facility so that they can be compared to the new films.
Tell the clinic if you have physical disabilities that may make it hard for you to sit up, lift your arms, or hold your breath.
Talk with the staff about how they will handle issues of modesty that you may have due to your religion.
Because mammography uses x-rays to produce images of the breast, patients are exposed to a small amount of ionizing radiation. For most women, the benefits of regular mammograms outweigh the risks posed by this amount of radiation. The risk associated with this dose appears to be greater among younger women (under age 40). However, in some cases, the benefits of using mammography to detect breast cancer under age 40 may outweigh the risks of radiation exposure. For example, a mammogram may reveal that a suspicious mass is benign and, therefore, doesn’t need to be treated. Additionally, if a tumor is malignant and is caught early by mammogram, a surgeon may be able to remove it before it spreads and requires more aggressive treatment such as chemotherapy.
Routine screening mammography is not done during pregnancy or while breastfeeding.
You will usually get the results within a few weeks, although it depends on the facility. A radiologist reads your mammogram and then reports the results to you and your doctor. If there is a concern, you will hear from the mammography facility earlier. Contact your health care provider or the mammography facility if you do not receive a report of your results within 30 days.
Breast tissue that shows no signs of a mass or calcifications is considered normal. Most abnormal findings on a screening mammogram turn out to be benign (not cancer) or nothing to worry about. New findings or changes must be further evaluated.
What can mammograms show?
The radiologist will look at your x-rays for breast changes that do not look normal and for differences in each breast. 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.
Possible mammogram findings include:
Lumps (mass or tumor). Lumps come in different sizes and shapes. Fluid-filled cysts are usually smooth and rounded, with clear, defined edges and are not cancer. Lumps that have a jagged outline and an irregular shape are of more concern.
Calcifications. There are two types of breast calcifications, or calcium deposits:
Macrocalcifications, which look like small white dots on a mammogram. They are often caused by aging, an old injury, or inflammation and are usually benign.
Microcalcifications, which look like white specks on a mammogram. If found in an area of rapidly dividing cells or grouped together in a certain way, they may be a sign of DCIS or breast cancer.
Dense breast tissue: A dense breast has relatively less fat and more glandular and connective tissue. This mammogram finding is both common and normal, especially among younger women and women who use menopausal hormone therapy. Dense breast tissue can make a mammogram more difficult to interpret because both dense breast tissue and breast tumors appear as solid white areas in the image.
What happens if my mammogram is normal?
Continue to get mammograms according to recommended time intervals. Mammograms work best when they can be compared with previous ones. This allows the radiologist to compare them to look for changes in your breasts.
What happens if my mammogram is abnormal?
An abnormal mammogram does not always mean that there is cancer. But you will need to have additional mammograms, tests, or exams before the doctor can tell for sure. You may also be referred to a breast specialist or a surgeon. It does not necessarily mean you have cancer or need surgery. These doctors are experts in diagnosing breast problems. Doctors may order some of these tests:
Diagnostic mammogram, to focus on a specific area of the breast
Ultrasound, an imaging test that uses sound waves to create a picture of your breast. The pictures may show whether a lump is solid or filled with fluid. A cyst is a fluid-filled sac. Cysts are not cancer. But a solid mass may be cancer. After the test, your doctor can store the pictures on video or print them out. This exam may be used along with a mammogram.
Magnetic resonance imaging (MRI), which uses a powerful magnet linked to a computer. MRI makes detailed pictures of breast tissue. Your doctor can view these pictures on a monitor or print them on film. MRI may be used along with a mammogram.
Biopsy, a test in which fluid or tissue is removed from your breast to help find out if there is cancer. Your doctor may refer you to a surgeon or to a doctor who is an expert in breast disease for a biopsy.
What is the Breast Imaging Reporting and Database System (BI-RADS®)?
The American College of Radiology (ACR) has established a uniform way for radiologists to describe mammogram findings. The system, called BI-RADS, includes seven standardized categories, or levels. Each BI-RADS category has a follow-up plan associated with it to help radiologists and other physicians appropriately manage a patient’s care.
Breast Imaging Reporting and Database System (BI-RADS)
Category
Assessment
Follow-up
0
Need additional imaging evaluation
Additional imaging needed before a category can be assigned
1
Negative
Continue regular screening mammograms
2
Benign (noncancerous) finding
Continue regular screening mammograms
3
Probably benign
Receive a 6-month follow-up mammogram
4
Suspicious abnormality
May require biopsy
5
Highly suggestive of malignancy (cancer)
Requires biopsy
6
Known biopsy-proven malignancy (cancer)
Biopsy confirms presence of cancer before treatment begins
BI-RADS also includes four categories of breast density that may be reported. The radiologist who reads the mammogram chooses the category that best describes the level of breast density seen on the mammogram film. The categories, from the least amount of breast density to the highest, are as follows:
The breasts are almost entirely fatty
There are scattered areas of dense glandular tissue and fibrous connective tissue (together known as fibroglandular density)
The breasts are heterogeneously dense, which means they have more of these areas of fibroglandular density. This may make it hard to see small masses in the breast tissue on a mammogram.
The breasts are extremely dense, which makes it hard to see tumors in the breast tissue on a mammogram.
Many states in the U.S. have enacted laws requiring mammography providers to tell women if they have dense breasts (i.e., breasts that are heterogeneously or extremely dense on a mammogram) and to inform them of risks associated with having dense breasts. In addition to making mammograms harder to read, dense breasts are a risk factor for breast cancer.
Although they are not perfect, mammograms are the best method to find breast changes that cannot be felt. 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.
As with any medical test, mammograms have limits. These limits include:
They are only part of a complete breast exam. Your doctor also should do a clinical breast exam. If your mammogram finds something abnormal, your doctor will order other tests.
Finding cancer does not always mean saving lives. Even though mammography can detect tumors that cannot be felt, finding a small tumor does not always mean that a woman's life will be saved. Mammography may not help a woman with a fast growing cancer that has already spread to other parts of her body before being found.
False negatives can happen. This means everything may look normal, but cancer is actually present. False negatives don't happen often. Younger women are more likely to have a false negative mammogram than are older women. The dense breasts of younger women make breast cancers harder to find in mammograms.
False positives can happen. This is when the mammogram results look like cancer is present, even though it is not. False positives are more common in younger women, women who have had breast biopsies, women with a family history of breast cancer, and women who are taking estrogen, such as menopausal hormone therapy.
Mammograms (as well as dental x-rays and other routine x-rays) use very small doses of radiation. The risk of any harm is very slight, but repeated x-rays could cause cancer. The benefits nearly always outweigh the risk. Talk to your doctor about the need for each x-ray. Ask about shielding to protect parts of the body that are not in the picture. You should always let your doctor and the technician know if there is any chance that you are pregnant.
https://www.womenshealth.gov/a-z-topics/mammograms [accessed on Feb 16, 2019]
https://www.nibib.nih.gov/science-education/science-topics/mammography [accessed on Feb 16, 2019]
https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm [accessed on Feb 16, 2019]
https://www.cancer.gov/types/breast/mammograms-fact-sheet [accessed on Feb 16, 2019]
https://www.cancer.gov/types/breast/breast-changes#ui-id-4 [accessed on Feb 16, 2019]
https://www.fda.gov/ForConsumers/ByAudience/ForWomen/WomensHealthTopics/ucm117967.htm [accessed on Feb 16, 2019]
https://medlineplus.gov/ency/article/003380.htm [accessed on Feb 16, 2019]
https://www.healthline.com/health/birads-score [accessed on Feb 16, 2019]
https://www.acr.org/-/media/ACR/Files/RADS/BI-RADS/Mammography-Reporting.pdf [accessed on Feb 16, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (48)
Mammography Fact Sheet
Mammography is an x-ray imaging method used to examine the breast for the early detection of cancer and other breast diseases. It is used as both a diagnostic and screening tool.
Document by www.nibib.nih.gov
Mammograms
Document by Office on Women's Health, U.S. Department of Health and Human Services
Top Four Mammogram Myths
Knowing the truth about mammograms could help save your life, or the life of someone you love. Over 60% of breast cancer cases are diagnosed before they spread. Nearly 90% of women who find and treat their breast cancer are cancer-free at five years. Mammograms can help reduce the number of deaths from breast cancer among women ages 40 to 70.
Image by The U.S. Food and Drug Administration
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations
Image by TheVisualMD
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Mammography
A woman getting a mammogram, showing a cone in position on her right breast.
Image by National Cancer Institute / Unknown Illustrator
Mammography
Image by BruceBlaus
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Mammogram
An adult female is assisted in a mammogram machine by an African-American technician.
Image by National Cancer Institute / Alan Hoofring (Illustrator)
Woman Having Mammogram
Photograph of woman having mammogram. Mammograms are considered the gold standard for breast cancer screening. Mammography requires the breasts to be compressed between plates while the image is captured. Typically, two views are taken of the breast: cranial-caudal (top to bottom) and mediolateral oblique (angled side view).
Image by TheVisualMD
Mammography
Mammogram being conducted
Image by CDC
Woman Receives Mammogram
An African-American female technician positions a Caucasian woman at an imaging machine to receive a mammogram.
Image by National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
A Caucasian female technician positions an Asian woman at an imaging machine to receive a mammogram.
Image by National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
A Caucasian female technician positions a Hispanic woman at an imaging machine to receive a mammogram.
Image by National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
An Asian female technician positions an African-American woman at an imaging machine to receive a mammogram.
Image by National Cancer Institute / Rhoda Baer (Photographer)
Mammography Patient
A female technician prepares to give an older Caucasian female patient a mammogram. the patient is preparing for the exam next to machine with technician in background adjusting controls.
Image by National Cancer Institute / Bill Branson (Photographer)
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Mammography
A woman's breast being compressed to get the optimum mammographic image.
Image by National Cancer Institute / Bill Branson (Photographer)
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Mammography
A Caucasian female patient, while sitting, is receiving a mammogram with a technician is standing in the background. The conical tip is compressing the right breast and the left breast is visible. Note the older machine.
Image by National Cancer Institute / Unknown Photographer
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Mammography
A Caucasian female patient receives a lateral mammogram treatment. She is lying on her left side with the left breast compressed and she is holding her right breast out of the way so as to not block the x-ray. Note the older methods of the diagnostic procedure.
Image by National Cancer Institute / Unknown Photographer
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Mammography
A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle that compresses the breast. The patient's face is turned towards the technician, away from the camera, and her right shoulder and breast are exposed.
Image by National Cancer Institute / Bill Branson (Photographer)
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Mammography
A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle used to compress the breast. The patient's face is turned towards the technician, away from the camera, with her right shoulder and breast are exposed.
Image by National Cancer Institute / Bill Branson (Photographer)
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Mammography Patient
A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle used to compress the breast. The patient's face is turned towards the technician, away from the camera. Her right shoulder is raised obscuring the breast.
Image by National Cancer Institute / Bill Branson (Photographer)
Male Breast Cancer
Senior Airman Elisabeth Stone compresses a male patient's breast tissue during a baseline screening of mammogram at Joint Base Elmendorf-Richardson, Alaska
Image by Staff Sgt. Sheila deVera
Doctor Viewing Mammogram
A doctor examines mammograms on a view box.
Image by National Cancer Institute / Bill Branson (photographer)
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Mammogram Showing Dense And Fatty Breasts
Title Mammogram Showing Dense And Fatty Breasts Description A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right). The dense breast is that of a woman aged 39, the fatty breast is that of a 59-year old woman. Abnormal lesions are easier to detect and diagnose in a fatty breast making mammography more accurate.
Image by Dr. Kathy Cho. NIH Radiology / National Cancer Institute
Abnormal Mammogram
This abnormal mammogram is not necessarily cancerous. Also seen are calcifications through ductal patterns. Patient would be avised to have follow-up at 3-month intervals.
Image by National Cancer Institute / Unknown Photographer
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Mammogram vs. MRI
A mammography on left and a Magnetic resonance image (MRI) on right. Breast imaging technology has changed over the years. Note MRI's enhancement ability to confirm diagnosis.
Image by Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania / Unknown Photographer
Bilateral digital mammography images of the breasts
Bilateral digital mammography images of the breasts; mediolateral oblique view.
Normal (left) versus cancerous (right) mammography image.
Normal (left) versus cancerous (right) mammography image.
Image by National Cancer Institute
Duct ectasia of breast
Detail of a mammography showing liponecrosis (round/oval calcifications) and plasma cell mastitis with typical rod-like calcifications
Image by Hellerhoff
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Mammogram - Normal
Breast tomosynthesis (3D Mammography) of the left craniocaudal.
Image by National Cancer Institute (NCI)
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Mammogram - Normal
Breast tomosynthesis (3D Mammography) of the left craniocaudal projection.
Image by National Cancer Institute (NCI)
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Mammogram - Normal
Breast tomosynthesis (3D Mammography) of the left craniocaudal reconstruction.
Image by National Cancer Institute (NCI)
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Mammogram - Normal
Breast tomosynthesis (3D Mammography) of the left mediolateral oblique projection.
Image by National Cancer Institute (NCI)
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Mammogram Showing Dense And Fatty Breasts
A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right). The dense breast is that of a woman aged 39, the fatty breast is that of a 59-year old woman. Abnormal lesions are easier to detect and diagnose in a fatty breast making mammography more accurate.
Image by Dr. Kathy Cho. NIH Radiology / Unknown Photographer
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Thermography of breast
Image by FDA
Mammograms vs Breast Ultrasounds
Video by Lee Health/Vimeo
Breast Density: Higher Risk & New Screening Options
Video by Breast Cancer School for Patients/YouTube
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Mammography: NCI B-roll [video]
NCI B-roll of female patient (simulated) receiving a digital mammogram. This video is intentionally silent. This footage, which was filmed at Sibley Memorial Hospital (a Johns Hopkins affiliate institution), includes images of a technician setting up the equipment, a Caucasian female being positioned to receive a mammogram, and mammography images of of dense breasts and fatty breasts. Downloadable video files are 960x540 at 30 fps. This image is part of the NCI B-Roll Videos collection.
View video using embedded player on this page or at youtube.com.
Video by National Cancer Institute (NCI)
What to Expect -- Digital Mammography
Video by Hologic, Inc./YouTube
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Mammography
Breast radiologist Dr.Gillian Newstead of the University of Chicago Medical Center explains the process of a typical mammogram screening.
Video by TheVisualMD
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Breast Density
Women with dense breast tissue often require a further look with ultrasound for screening. University of Chicago Medical Center breast radiologist Dr. Gillian Newstead and a breast cancer survivor with dense breast tissue explain.
Video by TheVisualMD
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Breast Cancer Screening & Diagnosis
Breast cancer is one of the most common cancers among women in the U.S., with about 1 in 8 women developing the disease within her lifetime. Breast cancer is an uncontrolled growth of breast cells that has the potential to spread into the breast and possibly to other parts of the body. Early detection through screening saves the lives of thousands of women every year. If there is a history of breast cancer in the family, women should consider the BReast CAncer susceptibility test (or BRCA) to identify a gene that may indicate an increased risk of developing the disease. Women forty and over should be screened for abnormalities yearly to detect and evaluate changes in breast tissue. If an abnormality is found, a biopsy and pathological exam are necessary for a definitive diagnosis and prognosis. After diagnosis, your doctor may want to learn more about your specific cancer through immunohistochemistry (IHC) and HER2 protein tests. IHC testing can help determine if a specific abnormality is present in the cancer cells. HER2 tests can tell your physician if the breast cancer is turned on by the HER2 gene, and can help determine the best course of treatment. Knowing what type of breast cancer is involved, what stage the cancer is, and the characteristics of that specific cancer, allows a woman's physician to determine best possible therapy for her individual case.
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A closer look at modern mammography
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Mammogram
A mammographic image is displayed on state of the art mammography monitors at the David Grant USAF Medical Center. (U.S. Air Force photo/Staff Sgt. Liliana Moreno)
Image by U.S. Air Force photo/Staff Sgt. Liliana Moreno
Nipple Aspirate Test No Substitute for Mammogram
Some companies are marketing a new test—the nipple aspirate test—as the latest and greatest tool in early breast cancer screening. But FDA warns that the nipple aspirate test is no substitute for a mammogram.
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Do More Screening Tests Lead to Better Health? Choosing Wisely
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New Guidelines for Mammograms
Video by Lee Health/Vimeo
Mammogram questions | Mercy Health
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Getting Screened for Breast Cancer
Video by Lee Health/Vimeo
Mammography Fact Sheet
www.nibib.nih.gov
Mammograms
Office on Women's Health, U.S. Department of Health and Human Services
Top Four Mammogram Myths
The U.S. Food and Drug Administration
Screening for Cancer
TheVisualMD
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Mammography
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Mammography
BruceBlaus
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Mammogram
National Cancer Institute / Alan Hoofring (Illustrator)
Woman Having Mammogram
TheVisualMD
Mammography
CDC
Woman Receives Mammogram
National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
National Cancer Institute / Rhoda Baer (Photographer)
Mammography Patient
National Cancer Institute / Bill Branson (Photographer)
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Mammography
National Cancer Institute / Bill Branson (Photographer)
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Mammography
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Mammography
National Cancer Institute / Unknown Photographer
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Mammography
National Cancer Institute / Bill Branson (Photographer)
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Mammography
National Cancer Institute / Bill Branson (Photographer)
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Mammography Patient
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Male Breast Cancer
Staff Sgt. Sheila deVera
Doctor Viewing Mammogram
National Cancer Institute / Bill Branson (photographer)
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Mammogram Showing Dense And Fatty Breasts
Dr. Kathy Cho. NIH Radiology / National Cancer Institute
Abnormal Mammogram
National Cancer Institute / Unknown Photographer
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Mammogram vs. MRI
Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania / Unknown Photographer
Bilateral digital mammography images of the breasts
Normal (left) versus cancerous (right) mammography image.
National Cancer Institute
Duct ectasia of breast
Hellerhoff
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Mammogram - Normal
National Cancer Institute (NCI)
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Mammogram - Normal
National Cancer Institute (NCI)
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Mammogram - Normal
National Cancer Institute (NCI)
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Mammogram - Normal
National Cancer Institute (NCI)
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Mammogram Showing Dense And Fatty Breasts
Dr. Kathy Cho. NIH Radiology / Unknown Photographer
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Thermography of breast
FDA
1:51
Mammograms vs Breast Ultrasounds
Lee Health/Vimeo
8:30
Breast Density: Higher Risk & New Screening Options
Breast Cancer School for Patients/YouTube
2:39
Mammography: NCI B-roll [video]
National Cancer Institute (NCI)
4:07
What to Expect -- Digital Mammography
Hologic, Inc./YouTube
0:37
Mammography
TheVisualMD
0:43
Breast Density
TheVisualMD
4:57
Breast Cancer Screening & Diagnosis
TheVisualMD
3:37
A closer look at modern mammography
Siemens Healthineers/YouTube
Mammogram
U.S. Air Force photo/Staff Sgt. Liliana Moreno
Nipple Aspirate Test No Substitute for Mammogram
The U.S. Food and Drug Administration
10:18
Do More Screening Tests Lead to Better Health? Choosing Wisely
DocMikeEvans/YouTube
1:41
New Guidelines for Mammograms
Lee Health/Vimeo
1:08
Mammogram questions | Mercy Health
Bon Secours Mercy Health/Vimeo
1:45
Getting Screened for Breast Cancer
Lee Health/Vimeo
What Is Breast Density?
Mammogram Showing Normal Fatty Breast
Image by Dr. Dwight Kaufman. National Cancer Institute
Mammogram Showing Normal Fatty Breast
A mammogram of a normal fatty breast, typical of older women. Diagnosis of abnormal lesions or cancer is more accurate in non-dense breasts.
Image by Dr. Dwight Kaufman. National Cancer Institute
What Is Breast Density?
Breast density reflects the amount of fibrous and glandular tissue in a woman’s breasts compared with the amount of fatty tissue in the breasts, as seen on a mammogram.
On a mammography report, breast density is assigned to one of the following four categories—
The breasts are almost entirely fatty (about 10% of women).
A few areas of dense tissue are scattered through the breasts (about 40% of women).
The breasts are evenly dense throughout (about 40% of women).
The breasts are extremely dense (about 10% of women).
Women in the first two categories are said to have low-density, non-dense, or fatty breasts. Women in the second two categories are said to have high-density or dense breasts. About half of women who are 40 years old or older have dense breasts.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (3)
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Breast Density
Women with dense breast tissue often require a further look with ultrasound for screening. University of Chicago Medical Center breast radiologist Dr. Gillian Newstead and a breast cancer survivor with dense breast tissue explain.
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Mammogram Showing Normal Dense Breasts
Two mammograms of normal dense breasts. A dense breast makes a mammographic image difficult to read when and if cancerous lesions are present. These images are typical of breast of younger women.Topics/Categories Anatomy -- Breast Test or Procedure -- Imaging ProceduresType B&W, PhotoSource Dr. Dwight Kaufman. Division Of Cancer Treatment
Image by Unknown photographer/National Cancer Institute
What Does It Mean to Have Dense Breasts?
Video by Centers for Disease Control and Prevention (CDC)/YouTube
0:43
Breast Density
TheVisualMD
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Mammogram Showing Normal Dense Breasts
Unknown photographer/National Cancer Institute
2:35
What Does It Mean to Have Dense Breasts?
Centers for Disease Control and Prevention (CDC)/YouTube
Breast Density Test
Breast Density Test
Also called: Breast Composition
Mammograms detect breast density, breast cancer, and breast changes that are not cancer (benign breast changes). Dense breasts have a high proportion of ductal and connective tissue, while less-dense breasts have a higher proportion of fatty tissue.
Breast Density Test
Also called: Breast Composition
Mammograms detect breast density, breast cancer, and breast changes that are not cancer (benign breast changes). Dense breasts have a high proportion of ductal and connective tissue, while less-dense breasts have a higher proportion of fatty tissue.
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Use the slider below to see how your results affect your
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Your result is (A) Fatty.
Your individual breast density classification on your recent mammogram is almost entirely fatty tissue, which is NOT considered "dense". Unless an area containing cancer is not included in the image field of the mammogram, mammography is highly sensitive in this setting. The sensitivity of mammography for detecting breast cancer decreases as the breast density increases.
Related conditions
https://www.acr.org/-/media/ACR/Files/RADS/BI-RADS/Mammography-Reporting.pdf [accessed on Feb 17, 2019]
https://www.mycdi.com/_asset/5lgdli/CDI-Quality-Institute-Breast-Density-Information-Document-6-15-16.pdf [accessed on Feb 17, 2019]
https://radiopaedia.org/articles/breast-density [accessed on Feb 17, 2019]
https://breast-cancer.ca/densitbi-rads/ [accessed on Feb 17, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
What Are the Parts of the Breast?
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Breast Anatomy
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Breast Anatomy
Breast tissue is made up of a variety of cells and includes fat blood vessels lymph vessels ligaments and nerves. The mammary glands are made up of multiple lobes which are subdivided into smaller lobules. Each lobule contains 10-100 raspberry-shaped alveoli connected in a branching network to larger milk ducts. The alveoli are the site of milk production and consist of clusters of specialized cells called lactocytes. Components are breast milk including proteins carbohydrates and milk fat globules are absorbed from the mother's blood stream and packaged in these lactocytes to become part of her breast milk.
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What Are the Parts of the Breast?
A woman’s breast has three kinds of tissue—
Fibrous tissue holds the breast tissue in place.
Glandular tissue is the part of the breast that makes milk, called the lobes, and the tubes that carry milk to the nipple, called ducts. Together, fibrous and glandular tissue are called fibroglandular tissue.
Fatty tissue fills the space between the fibrous tissue, lobes, and ducts. It gives the breasts their size and shape.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
Breast Anatomy
Video by khanacademymedicine/YouTube
4:10
Breast Anatomy
khanacademymedicine/YouTube
Why Is Breast Density Important?
The Marvel of the Breast
Image by TheVisualMD
The Marvel of the Breast
The breast is a mass of glandular, fatty, and fibrous tissues positioned over the pectoral muscles of the chest wall. Each breast contains several milk glands with ducts that carry milk to the nipples.
Image by TheVisualMD
Why Is Breast Density Important?
Breast Cancer Risk
Women with dense breasts have a higher chance of getting breast cancer. The more dense your breasts are, the higher your risk. Scientists don’t know for sure why this is true.
Breast cancer patients who have dense breasts are not more likely to die from breast cancer than patients with non-dense (fatty) breasts.
Mammograms
Dense tissue can hide cancers. Fibrous and glandular tissue looks white on a mammogram. So does a possible tumor. Because it’s hard to tell the difference between a tumor and dense breast tissue on a mammogram, a small tumor may be missed.
The image on the left shows a mostly fatty breast, and the image on the right shows a dense breast.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
Why Is Breast Density Important? - Mayo Clinic Breast Clinic
Video by Mayo Clinic/YouTube
1:00
Why Is Breast Density Important? - Mayo Clinic Breast Clinic
Mayo Clinic/YouTube
Who Is More Likely to Have Dense Breasts?
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Breast Density
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Breast Density
Image by TheVisualMD
Who Is More Likely to Have Dense Breasts?
The density of your breasts can change over time. Generally, you’re more likely to have dense breasts if you—
Are younger.
Are pregnant or breastfeeding.
Are taking hormone replacement therapy.
Have a lower body weight.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
Breast Density: Higher Risk & New Screening Options
Video by Breast Cancer School for Patients/YouTube
8:30
Breast Density: Higher Risk & New Screening Options
Breast Cancer School for Patients/YouTube
What Should I Do If I Have Dense Breasts?
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Mammogram Showing Dense And Fatty Breasts
Image by Dr. Kathy Cho. NIH Radiology / National Cancer Institute
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Mammogram Showing Dense And Fatty Breasts
Title Mammogram Showing Dense And Fatty Breasts Description A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right). The dense breast is that of a woman aged 39, the fatty breast is that of a 59-year old woman. Abnormal lesions are easier to detect and diagnose in a fatty breast making mammography more accurate.
Image by Dr. Kathy Cho. NIH Radiology / National Cancer Institute
What Should I Do If I Have Dense Breasts?
Talk to your doctor about your personal risk of getting breast cancer. Dense breasts are just one of several risk factors for breast cancer. Your doctor will also think about other factors, like your age and family history of cancer.
Different tests may be able to find some cancers that are missed on a mammogram. But these tests are more likely to have a false positive result (the test is reported as abnormal, but you really don’t have cancer). False positive test results often lead to unnecessary tests, like a biopsy. Also, you may have to pay for these tests.
Your doctor may suggest one of these tests—
Breast ultrasound. A machine that uses sound waves to make detailed pictures, called sonograms, of areas inside the breast.
Magnetic resonance imaging (MRI). A kind of body scan that uses a magnet linked to a computer. The MRI scan makes detailed pictures of areas inside the breast.
Talk with your doctor about how often you should be screened for breast cancer and which tests your doctor recommends.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
How To Decide What To Do If You Have Dense Breasts On Mammogram - Mayo Clinic Breast Clinic
Video by Mayo Clinic/YouTube
6:45
How To Decide What To Do If You Have Dense Breasts On Mammogram - Mayo Clinic Breast Clinic
Mayo Clinic/YouTube
Breast Ultrasound
Breast Ultrasound
Also called: Breast Ultrasonography, Breast Sonogram, Ultrasound - Breast, Breast Ultrasound
A breast ultrasound is a noninvasive, painless, and risk-free imaging test in which an ultrasound machine is used to evaluate your breast tissue.
Breast Ultrasound
Also called: Breast Ultrasonography, Breast Sonogram, Ultrasound - Breast, Breast Ultrasound
A breast ultrasound is a noninvasive, painless, and risk-free imaging test in which an ultrasound machine is used to evaluate your breast tissue.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that no abnormalities or masses were found in your breast tissue.
Related conditions
A breast ultrasound is an imaging test that uses an ultrasound machine to evaluate your breasts.
This test is most helpful to differentiate a solid mass (such as a tumor) from a fluid-filled mass (such as a cyst).
Your doctor may want to order this test in the following situations:
As the first test to examine young women (usually less than 35-year-old) who have breast symptoms, such as pain, lumps, or abnormal nipple discharge
As a follow-up test if a clinical breast exam or mammogram has revealed an abnormality
To evaluate breast tissue that is obscured by breast implants
To evaluate breast tissue in pregnant women
To guide the placement of a needle during breast biopsies
It is important to point out that a breast ultrasound is not usually done to screen for breast cancer because some early signs of cancer can be easily missed with this test.
You will be asked to remove your bra and lie down on your back with your chest exposed. Then, a healthcare practitioner will place a triangular sponge behind your shoulder, so that you are slightly tilted onto your side.
Then, a water-based gel will be applied on the skin of one of your breasts, and a small probe will be used to visualize your breast tissue on a screen. This will be repeated on the other breast as well.
Your axilla (armpit) will also be examined during the test to assess for any lumps or enlarged lymph glands.
The procedure usually takes no more than 30 minutes, and there is no need for an anesthetic because it’s painless.
No special preparations are needed. You may want to wear a two-piece outfit so that only your top has to be removed during the test.
There are no risks related to a breast ultrasound test.
A normal result means that no abnormalities or masses were found in your breast tissue.
An abnormal result indicates that a problem was detected, including but not limited to:
Cysts, which are fluid-filled sacs
Solid tumors, which can be cancerous or non-cancerous
Fibroadenomas (non-cancerous solid growths)
Lipomas (non-cancerous fatty tumors)
This test can provide information about the location, size, and structure of breast tumors, but cannot provide a definite diagnosis of cancer.
https://www.insideradiology.com.au/breast-ultrasound/ [accessed on Mar 12, 2019]
https://www.webmd.com/breast-cancer/breast-ultrasound [accessed on Mar 12, 2019]
https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gynecology/breast_ultrasound_92,p07764 [accessed on Mar 12, 2019]
https://medlineplus.gov/ency/article/003379.htm [accessed on Feb 16, 2019]
https://ww5.komen.org/BreastCancer/Ultrasound.html [accessed on Feb 16, 2019]
https://www.health.ny.gov/diseases/cancer/breast/nys_breast_cancer_faqs.htm [accessed on Feb 16, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
Diagnosing Breast Cancer
If a woman has symptoms of breast cancer (such as a lump), or if a suspicious area is found in an imaging exam, the next step is to physically examine the breasts by noting any changes in their appearance and palpating the breast and the underarm region. A complete physical exam may be done as well. If symptoms or results of these exams suggest cancer might be present, then further tests will be done. (Note: The following diagnostic procedures are common to the US; procedures may vary in other countries.)
Image by TheVisualMD
Tubular carcinoma of breast ultrasound
Ultrasound images of tubular carcinoma of breast. Tonemapped
Dense Breasts: Answers to Commonly Asked Questions
What are dense breasts?
Breasts contain glandular tissue, fibrous connective tissue, and fatty breast tissue. Breast density is a term that describes the relative amount of these different types of breast tissue as seen on a mammogram. Dense breasts have relatively high amounts of glandular tissue and fibrous connective tissue and relatively low amounts of fatty breast tissue.
Are dense breasts common?
Yes, dense breasts are common. Nearly half of all women who are 40 and older who get mammograms are found to have dense breasts.
What factors influence breast density
Breast density is often inherited, but other factors can influence it.
Factors associated with higher breast density include using menopausal hormone therapy and having a low body mass index.
Factors associated with lower breast density include increasing age and having children.
How do I know if I have dense breasts?
Dense breast tissue cannot be felt by a woman, such as during a breast self-exam, or by her doctor during a clinical breast exam. Only a radiologist looking at a mammogram can tell if a woman has dense breasts. Dense breasts are sometimes called mammographically dense breasts.
How is breast density categorized in a mammogram report?
Doctors use the Breast Imaging Reporting and Data System (BI-RADS) to classify breast density. This system, developed by the American College of Radiology, helps doctors interpret and report back mammogram findings. Doctors who review mammograms are called radiologists. BI-RADS classifies breast density into four categories:
Entirely fatty breast tissue: There is almost all fatty breast tissue. It is found in about 10% of women.
Scattered fibroglandular breast tissue: There is mostly fatty tissue with some areas of dense glandular and fibrous connective tissue. It is found in about 40% of women.
Heterogeneously dense breast tissue: There are many areas of dense glandular and fibrous connective tissue, with some areas of fatty tissue. It is found in about 40% of women
Extremely dense breast tissue: There is almost all dense glandular and fibrous connective tissue. It is found in about 10% of women.
If your mammogram report letter says you have dense breasts, it means that you have either heterogeneously dense breast tissue or extremely dense breast tissue.
The four breast density categories are shown in this image. Breasts can be almost entirely fatty (A), have scattered areas of dense fibroglandular breast tissue (B), have many areas of glandular and connective tissue (C), or be extremely dense (D). Breasts are classified as “dense” if they fall in the heterogeneously dense (C) or extremely dense (D) categories.
Does having dense breast tissue affect a mammogram?
Dense breasts can make a mammogram more difficult to interpret. That's because dense breast tissue and some abnormal breast changes, such as calcifications and tumors, both appear as white areas in the mammogram, whereas fatty tissue appears as dark areas.
As a result, mammography is less sensitive in women with dense breasts—that is, it is more likely to miss cancer. Women with dense breasts may be called back for follow-up testing more often than women with fatty breasts.
Are dense breasts a risk factor for breast cancer?
Dense breasts are not considered an abnormal breast condition or a disease. However, dense breasts are a risk factor for breast cancer. That is, women with dense breasts have a higher risk of breast cancer than women with fatty breasts. This risk is separate from the effect of dense breasts on the ability to read a mammogram.
In most states, mammography providers are required to inform women if they have dense breasts.
Should women with dense breasts have additional screening for breast cancer?
The value of additional, or supplemental, imaging tests such as ultrasound or MRI to screen for breast cancer in women with dense breasts is not yet clear, according to the Recommendation Statement on Breast Cancer Screening by the United States Preventive Services Task Force (USPSTF). Talk with your doctor or nurse to learn what is recommended for you, based on your personal medical history and family medical history.
Are breast cancer patients with dense breasts more likely to die from breast cancer?
No. Research has found that breast cancer patients who have dense breasts are no more likely to die from breast cancer than breast cancer patients who have fatty breasts, after accounting for other health factors and tumor characteristics.
Questions to consider asking your doctor or nurse
Ask these questions to get information that’s specific to you, based on your personal medical history:
What are the dense breast-related findings in my recent mammogram?
Do you recommend additional screening or diagnostic tests for me?
What is my overall personal risk of breast cancer, given my risk and protective factors?
Are there clinical trials for women with dense breasts?
Yes, there are ongoing and completed clinical trials related to dense breasts that are studying better ways to detect breast cancer in women with dense breasts.
What are researchers studying about the relationship between breast density and breast cancer?
Here are some questions that researchers are working to answer:
Can imaging tests such as 3-D mammography, MRI, ultrasound, or other imaging procedures help provide a clearer picture of breast density?
Are there certain patterns or areas of dense breast tissue that are particularly “risky”?
Why do some women with dense breasts develop breast cancer, whereas others do not?
What biologic mechanisms explain the association between high breast density and increased breast cancer risk?
Can biomarkers be identified that may help predict whether breast cancer will develop in a woman with dense breasts?
Are changes in breast density over time associated with changes in breast cancer risk?
Can women reduce their breast density, and potentially their risk of developing or dying from breast cancer, by taking medicines or by applying topical agents on their breasts?
Source: National Cancer Institute (NCI)
Additional Materials (4)
What Are Dense Breasts? | FAQ with Dr. Kelly Myers
Video by Johns Hopkins Medicine/YouTube
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Dense Breasts and Cancer
Among U.S. women age 40-74, 40% to 50% have dense breasts. Women with dense breasts have a higher risk of breast cancer.
Image by National Cancer Institute (NCI)
What is dense breast tissue? - Mayo Clinic
Video by Mayo Clinic/YouTube
How To Decide What To Do If You Have Dense Breasts On Mammogram - Mayo Clinic Breast Clinic
Video by Mayo Clinic/YouTube
3:36
What Are Dense Breasts? | FAQ with Dr. Kelly Myers
Johns Hopkins Medicine/YouTube
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Dense Breasts and Cancer
National Cancer Institute (NCI)
1:33
What is dense breast tissue? - Mayo Clinic
Mayo Clinic/YouTube
6:45
How To Decide What To Do If You Have Dense Breasts On Mammogram - Mayo Clinic Breast Clinic
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Breast Density
A woman's breast has three kinds of tissue; fibrous, glandular, and fatty tissue. Having more fibrous and glandular tissue than fatty tissue means the breasts are more dense. Women with dense breasts have a higher risk of getting breast cancer. A mammogram can show you if your breasts have low or high density. Find out more about breast density.