What You Need to Know about Mammograms

Is five minutes of a little discomfort worth your life? Early detection is proven to increase survival and maintain quality of life. In fact, the earlier breast cancer is found, the better the chances that treatment will work, according to the American Cancer Society. Screening exams, such as mammograms, can often find breast cancers when they are small and still confined to the breast. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis of a woman with this disease.

Early detection tests save lives. A team of radiologists at St. Luke’s Health-Memorial interprets the results of nearly 1,000 mammograms every month, but Board Certified Diagnostic Radiologist Harold R. Levine, II M.D. says they would certainly like to see more women taking control of their health and taking the time to get their yearly mammogram.

“Over the past ten years, digital mammography has improved with lower doses of radiation and clearer images,” Dr. Levine said. “It’s a five minute ordeal, and the American Cancer Society suggests you have it done every year.”

Dr. Levine also says having your mammogram done at the same facility each year can make a difference.

“The first thing we do as radiologists is compare the older mammogram to the new one,” Dr. Levine said. “If we see something that may be concerning, we’re going to look and see if the breast looks the same as it did a year ago, or two years ago. So find a place you like and stick with it.”

If you are new to the area, be sure to bring your older screenings with you which can result in less wasted time and undue stress.

Patients can access their records, but Dr. Levine warns the medical terminology within the report can be confusing. Radiologists use a standard system to describe mammogram findings and results sorted into categories numbered 0 through 6. This system, called the Breast Imaging Reporting and Data System or BI-RADS, allows radiologists all over the country to describe what they find on a mammogram using the same words and terms. This makes accurately communicating about these test results and following up after the tests much easier.

 “These reports can sound scary to someone who is not well versed in medical language,” Dr. Levine said. “So the most important thing to look at is the category number, or BI-RADS number.”

Category 0 – Follow up is needed. The scan may be incomplete or additional imaging is needed. It doesn’t necessarily mean cancer is present, but more tests need to be done.
Category 1 – Negative. There’s no significant abnormality to report.
Category 2 –Benign (non-cancerous) finding. This is also a negative mammogram result.
Category 3 – Probably benign finding. Imaging follow up is recommended. The findings have a very high chance (greater than 98%) of being benign.
Category 4 – Suspicious. Additional imaging and biopsy is recommended.
Category 5 – Highly suspicious for malignancy. There is a 95% or greater chance that cancer is present.
Category 6 – Known biopsy-proven malignancy. This category is only used for findings on a mammogram that have already been shown to be cancer by a previous biopsy.

It’s important to note these categories are not the same as stages of cancer.

Dr. Levine reminds women that a follow-up mammogram or breast ultrasound doesn’t always mean a cancer diagnosis. However, sometimes it does. Early prevention, such as yearly mammograms and quarterly self-breast exams, and following doctor’s orders is key to better outcomes. Yearly screening should begin at age 45, or at age 40 depending on family history of breast cancer.

The technicians at St. Luke’s Health-Memorial who perform the mammograms are certified by the American Registry of Radiologic Technologists.

“We try to make this process as easy and female friendly as possible,” said Chris Beasley, System Director of Imaging Services. “We have a women’s only waiting room and our mammography technologists are all women. It’s a very thoughtful process so our patients never feel exposed or uncomfortable. A mammogram may not be the most fun you have all year, but it we want it to be a quick and easy way to possibly save your life.”