Mammogram

Mammograms play 2 very important roles in a person’s breast health. Depending on your health story, your doctor will order 1 or both of the following mammograms.

1. Screening mammogram: This is for people who don’t have symptoms or known breast problems. A screening mammogram is part of a preventive breast health care plan.
2. Diagnostic mammogram: This is for people who have breast symptoms. It's also used as a follow-up to a screening mammogram that detected something abnormal.

Routine screening mammograms involve taking several images of each breast. There may be some cases where your care team will need additional views with a slightly different angle or position to clear up any questions. Many people are cleared by a diagnostic mammogram and require no additional testing until their next screening mammogram.

The radiologists who analyze your mammogram will report their findings within 1 week to your primary care doctor, gynecologist, oncologist or other members of your care team.

Our mammography facilities are licensed by the Massachusetts Department of Public Health and accredited by the American College of Radiology.

3D mammogram

3D mammography, or tomosynthesis, gives us the power to detect lumps hidden by overlapping breast tissue. It works by first taking 2D images of the breasts. We then layer those images on top of each other, creating a 3D image of the breasts. This allows us to look at breast tissue one layer at a time and see the fine details more clearly than 2D images alone.

What if my 3D mammogram detects something abnormal? 

Mammograms are often the first course of action for detecting any suspicious changes in breast health. Because they can’t say for certain what is and isn’t breast cancer, we turn to follow-up tests to confirm a diagnosis.

If we find something abnormal or suspicious in your 3D mammogram, we may order a breast ultrasound or diagnostic mammogram as a follow-up test.

A breast ultrasound only takes about 20 minutes to complete. During this test, a sonographer scans the breast area using sound waves to produce images our radiology team analyzes.

And as for a diagnostic mammogram, we zero in on the area in question by compressing the breast tissue differently. That's why this test is sometimes called a "spot" or "compression" view.

Understanding breast density

Advances in technology now allow our radiologists to grade a person's breast density. When you turn to Tufts Medicine for your annual 3D mammogram, you'll also receive your latest breast density grading.

To understand what each grade represents, it's helpful to know the 5 core components of the breasts and the roles they play in your breast health:

1. Lobules: These are the glands that produce milk.
2. Ducts: These are the small tubes that flow milk from the lobules to the nipple. 
3. Glandular tissue: The lobules and ducts make up glandular tissue. 
4. Fibrous tissue: Also known as connective tissue, it protects and holds bones, muscles, organs and tissues in place. Along with fat, fibrous tissue is what gives breasts their size and shape. 
5. Fat tissue: This fills in the space between the glandular and fibrous tissues. 

Breast density measures how much fibrous and glandular tissue (together known as fibroglandular tissue) are in the breast tissue compared to fat tissue. We record this ratio with these breast density grading categories:

• A: Breasts are mostly made of fatty tissue.
• B: Breasts have scattered areas of dense fibroglandular tissue.
• C: Breasts have large areas of fibroglandular tissue, also described as heterogeneously dense. The density of tissue can make it challenging to spot masses or other breast changes on a mammogram. 
• D: Breasts have extremely dense areas of fibroglandular tissue, making it difficult to detect masses or other changes on a mammogram. 

Nearly half of all women and AFABs live with dense breasts (grades C and D), so we'll talk with you about what breast density means for your health and how to remain proactive with breast health with the right screenings.