A mammogram is a low-dose X-ray of the breast used to detect changes in breast tissue. This screening tool is a key part of routine preventive care for many women. After the imaging is complete, a radiologist interprets the results and sends a report to your doctor. Here is some information about decoding your mammogram results:
Reading the BI-RADS Score
Your mammogram report will include a score from the Breast Imaging Reporting and Data System, or BI-RADS. This system sorts exam findings into categories numbered 0 through 6. Each number corresponds to a specific assessment and follow-up plan.
A score of 0 means the assessment is incomplete, often because the images were not clear or the radiologist wants to compare them with previous mammograms. A score of 1 signifies that your mammogram is negative, with no signs of cancer. Similarly, a score of 2 indicates a benign non-cancerous finding, like a cyst.
A score of 3 suggests a finding that is likely benign, with a low risk of cancer. Scores of 4 and 5 indicate a suspicious finding. A score of 4 is a suspicious abnormality, while a 5 indicates a finding that is highly suggestive of malignancy. A score of 6 is only used for findings on a mammogram that are already known to be cancerous from a previous biopsy.
Understanding Breast Density Classifications
The report will also describe your breast density. Breast tissue is composed of fat, fibrous tissue, and glandular tissue. Breast density refers to the amount of fibrous and glandular tissue compared to the amount of fat. Denser breasts have more fibrous and glandular tissue. There are four categories of breast density:
- Almost entirely fatty: The breasts are made up of almost all fat, making abnormalities easy to detect.
- Scattered areas of fibroglandular density: There are some scattered areas of density, but most of the breast tissue is fatty.
- Heterogeneously dense: The breasts have many areas of fibrous and glandular tissue, which might obscure small masses.
- Extremely dense: The breasts have a high amount of fibrous and glandular tissue, which reduces mammographic sensitivity.
Knowing your breast density is useful because dense breast tissue can make it harder for radiologists to see cancer on a mammogram. Women with dense breasts may have a higher risk of developing breast cancer. Your healthcare provider will discuss what your breast density means for you.
Determining Next Steps
The steps following your mammogram depend on your BI-RADS score and breast density. If your results are negative, your provider will likely recommend you continue with your regular screening schedule. For incomplete results, you will need to return for additional imaging.
If your report shows a probably benign finding, you will be asked to return for a follow-up exam to monitor for any changes. For suspicious results, the recommendation is typically a biopsy to examine the tissue more closely. Your doctor will walk you through this process and explain what to expect.
Schedule a Mammogram
Receiving and understanding your mammogram results is a proactive part of managing your health. This report provides a detailed assessment of your breast tissue and offers clear guidance for follow-up care. Your healthcare team will help you navigate the next steps based on your specific results. Contact an OBGYN today to book your next mammogram appointment.
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