On a mammogram, breast tissue appears gray or white. Dense tissue is white and contains less fat. However, a focused white area with clear edges may be a cancerous or noncancerous tumor.

Mammograms are X-ray images of the breast that can reveal early signs of breast cancer. There are two techniques for creating a mammogram: Film-screen mammography creates a photographic film, and digital mammography creates digital images.

Both methods use the same procedure for taking the image. The person having the mammogram will place their breast between two clear plates, which will squeeze it between them to hold it in place. This flattens the breast for a better image and stops the image from blurring.

The machine takes a picture of the breast from two angles. A specialist then checks the mammogram for anything unusual that could be a sign of cancer.

The whole procedure takes about 20 minutesTrusted Source. Some people may feel slight pain or discomfort.

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A mammogram is an image of the breast. The background is black, and the breast appears in grays and whites.

Tissue that is more dense, including connective tissue and glands, appears white.

Some people have more denseTrusted Source tissue in their breasts. This can make detecting abnormalities on a mammogram harder as a tumor consists of dense tissue and will also appear white.

The breasts tend to become less denseTrusted Source with age. Less dense tissue, such as fat, appears gray on a mammogram.

A standard mammogram will usually be mostly gray, with some white areas showing healthy, dense tissue. More white on the image does not always indicate a health issue.

Everyone’s breasts are different, so no two mammogram images will be the same. Healthy mammograms can still vary in appearance.

A medical professional who checks imaging tests, such as X-rays or MRI scans, is called a radiologist. They will look carefully at the mammogram to interpret the results.

Any area that does not look like regular tissue is a possible cause for concern. The radiologist will look for areas of white, high-density tissue and note its size, shape, and edges.

A lump or tumor will show upTrusted Source as a focused white area on a mammogram or can be shades of gray. Tumors can be cancerous or benign (noncancerous).

If a tumor is benign, it is not a health risk and is unlikely to grow or change shape. tumors in the breasts are noncancerous.

Small white specks, also known as calcifications, are often noncancerous. However, the radiologist will check their shape and pattern, as they can sometimesTrusted Source be a sign of cancer.

As well as dense breast tissue and possible tumors, a radiologist will look for anything unusual on a mammogram.

Other abnormalities include:

  • Cysts: These are small fluid-filled sacs — most are simple cysts, which have a thin wall and are not cancerous. If a doctor cannot classify a cyst as a simple cyst, they may order further tests to ensure it is not cancerous.
  • Calcifications: These are deposits of calcium. Larger deposits are called macrocalcifications and usually occur due to aging. Smaller deposits are called microcalcifications. Depending on their appearance, a doctor may biopsy the calcifications to determine if they are malignant.
  • Fibroadenomas: These are benign tumors in the breast. They are round and may feel like a marble. People in their 20s and 30s are more likelyTrusted Source to have a fibroadenoma, but they can occur at any age.
  • Scar tissue: This often appears white on a mammogram. It is best for a person to make a doctor aware of any scarring on the breasts beforehand.

A mass may refer to a tumor, cyst, or fibroadenoma, whether it is cancerous or not.

A mammogram can also give a person information about their breast density. People with dense breasts have a slightly higher riskTrusted Source of breast cancer. Dense breasts can make it more difficult to find abnormalities on a mammogram.

Mammograms are still possible if a person has had breast cancer surgery or implants. However, it may be necessary to take more images of each breast, and it might take longer to check the images.

A radiologist will often compare a mammogram against previous images. This can help them spot any changes and decide whether an unusual area could be a sign of cancer.

There is a standard system for reporting mammogram results called the Breast Imaging-Reporting and Data System (BI-RADS).

BI-RADS uses categories from 0 to 6Trusted Source. This is to make sure that radiologists across the United States standardize their interpretations of breast imaging.

CategoryMeaning
0unclear result with a need for more tests or comparison with previous mammograms
1no abnormalities
2no sign of cancer — benign findings
3likely benign findings — close follow-up recommended, usually in 6 months
4suspicious findings — a biopsy is recommended
5highly suspicious for cancer — biopsy highly recommended
6cancer is present, requiring mammograms to check progress

A medical professional should explain the results clearly. They may recommend further tests to check anything that needs further investigation.

It is commonTrusted Source to need further tests after a mammogram, as doctors will want to look more closely at any abnormalities on the images. A callback does not necessarily mean that cancer is present.

People should examine their breasts regularly and consult a doctor if they have any concerns.

Being aware of how their breasts usually look and feel can make a person more likely to notice any changes.

Routine screening

Undergoing a mammogram to detect breast cancer in its early stages is known as screening.

If a person has any symptoms of breast cancer, such as a palpable mass, bloody nipple discharge, or skin changes, they will undergo a diagnostic mammogram. This is a more in-depth mammogram than a screening mammogram.

Guidelines from the U.S. Preventive Services Task Force recommend that all women get screened for breast cancer every other year, starting from the age of 40 years.

The American Cancer Society (ACS)Trusted Source has a different set of recommendations:

  • Women ages 40 to 44: People in this group should have the choice to start annual mammograms if they wish to.
  • Women ages 45 to 54: Mammograms every year.
  • Women ages 55 and above: Switch to mammograms every 2 years.

The ACS also recommends that those with the following high risk factors may need to undergo more frequent screening:

  • a history of breast cancer
  • genetic factors, such as changes in the BRCA1 or BRCA2 gene
  • a history of chest radiation exposure before 30 years old

Alternatively, the American College of Radiology recommends the following:

  • All women — particularly Black and Ashkenazi Jewish women — should have a risk assessment by age 25 years to determine whether screening earlier than age 40 is necessary.
  • Women with a genetic risk of breast cancer should start annual mammograms at ages 25 to 40 years.
  • Women with a diagnosis of breast cancer before the age of 50 years should have yearly supplemental breast MRIs.
  • High-risk women who cannot undergo MRI screening but desire supplemental screening should consider contrast-enhanced mammography. This combines traditional mammography with the use of a special dye injected into a vein. This helps highlight areas of the breast where there might be abnormal tissue.

The most important thing is for a person to ask their doctor for the best course of action for them.

Are white spots on a mammogram cancer?

White spots on a mammogram usually point toTrusted Source calcifications, which are tiny calcium deposits within the breast tissue that may or may not be due to cancer.

Can you tell if someone has breast cancer from a mammogram?

Yes, a mammogram can detect signs of breast cancer. However, an additional mammogram or biopsy may beTrusted Source necessary for a definitive diagnosis.

What are two areas of concern on a mammogram?

Two areas of possible concern in a mammogram includeTrusted Source small white spots, known as calcifications, and the appearance of distorted breast tissue. This is called architectural distortion and asymmetries.

These two features can sometimes point to a person having cancer, but not always.

Mammograms are currently the best method available for detecting breast cancer or checking how breast cancer is responding to treatment. However, mammograms are not perfect, and it can be difficult to detect any abnormalities in people with dense breasts.

A mammogram will look different for everyone, and there is no standard normal or abnormal image.

Areas that appear white on a mammogram may need follow-up tests but are not often the result of breast cancer.

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