Breast Calcifications: Accuracy of Mammograms and Ultrasounds

Breast calcification

Doctor: I would like to ask what the accuracy of mammography is.
I had a mammogram and an ultrasound at this hospital last time, but I am still very anxious.
I also consulted with the doctor, who said it was benign, but can we be sure it is benign without a biopsy? Originally, I had an ultrasound at a small obstetrics and gynecology clinic in Taoyuan, and the doctor mentioned calcifications, recommending that I go to a larger hospital for further evaluation.
However, the area that was imaged last time is right in the center of the nipple, and it seems different from the area the doctor examined during the previous ultrasound, which makes me very worried.
Therefore, I would like to know if mammograms can detect all abnormalities.
Additionally, the clinic is often crowded; is there a time when it is less busy? Thank you.

Zhang Xiaojie, 30~39 year old female. Ask Date: 2010/06/17

Dr. Wu Jingtang reply Breast and Thyroid

Dear Miss Chang,
The accuracy of mammography and ultrasound is approximately 60-70%.
Generally, we assess the characteristics of the images to determine whether a tumor is benign or malignant.
However, there are still some situations that cannot be fully controlled, and certain tumors or diseases may not be detected with 100% accuracy by these two modalities.

The fine needle aspiration cytology method can certainly provide additional information.
If you are still very concerned, I recommend that you return for a follow-up appointment in a shorter time frame (such as 3 months) to check for any changes in the ultrasound.
If necessary, a mammogram can be performed to make a more informed decision.

As for the outpatient clinic, there are usually fewer patients on Monday afternoons.

Wishing you peace and health!
Sincerely,
Dr.
Wu Ching-Tang
Attending Surgeon, Taoyuan Hospital, Department of Health

Reply Date: 2010/06/17

More Info

Understanding breast calcifications and the accuracy of mammograms and ultrasounds is crucial for women’s health, especially when concerns about breast cancer arise. Breast calcifications are small deposits of calcium in the breast tissue, which can be detected through mammography. They are often categorized as benign (non-cancerous) or suspicious, depending on their appearance and pattern.

Accuracy of Mammograms
Mammograms are a vital tool in breast cancer screening and diagnosis. The accuracy of mammograms can vary based on several factors, including the density of breast tissue and the skill of the radiologist interpreting the images. Generally, mammograms have a sensitivity of about 80-90% for detecting breast cancer, meaning they can miss about 10-20% of cancers, especially in women with dense breast tissue. This is why additional imaging, such as ultrasound, is often recommended when calcifications or other abnormalities are detected.

Role of Ultrasound
Ultrasound is frequently used as a complementary tool to mammography. It is particularly useful for evaluating breast lumps or areas of concern identified on a mammogram. Ultrasound can help differentiate between solid masses and fluid-filled cysts, and it can provide additional information about the characteristics of a lesion. However, it is important to note that ultrasound does not replace mammography; rather, it enhances the diagnostic process.

Understanding Calcifications
Calcifications can appear in various forms on a mammogram. Benign calcifications are usually small, scattered, and do not form clusters. In contrast, suspicious calcifications may appear in clusters or have irregular shapes, which could indicate the presence of cancer. If calcifications are detected, further evaluation may be necessary, which could include additional mammograms, ultrasounds, or even a biopsy to determine their nature.

Diagnosis Without Biopsy
In some cases, a doctor may determine that a lesion is benign based on imaging characteristics without performing a biopsy. This decision is often made when the imaging results are consistent with benign findings and there are no concerning features. However, if there is any doubt or if the lesion has atypical characteristics, a biopsy may be recommended to obtain a definitive diagnosis.

Follow-Up and Monitoring
If you have been advised that your findings are benign, it is still essential to follow up with your healthcare provider as recommended. Regular monitoring through mammograms and clinical breast exams is crucial, especially if you have a history of breast issues or if there are changes in your breast tissue.

Addressing Your Concerns
It is understandable to feel anxious about breast health, especially after receiving conflicting information from different healthcare providers. If you have concerns about the calcifications or any changes in your breast tissue, it is important to communicate these with your doctor. They can provide clarity on the findings and discuss the next steps, whether that involves further imaging or a biopsy.

Scheduling and Access to Care
Regarding your concern about busy clinics, it is often possible to schedule appointments during less busy times, such as early mornings or mid-afternoons. You can call the clinic ahead of time to inquire about the best times to schedule your appointment to minimize wait times.

In summary, while mammograms are a reliable screening tool, they are not infallible. If calcifications are detected, further evaluation through ultrasound or biopsy may be warranted to ensure accurate diagnosis and appropriate management. Always feel empowered to ask questions and seek clarification from your healthcare provider about your breast health and any recommended follow-up actions.

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