Your guide to breast cancer screening terminology

Preena Patel, a physician assistant who specializes in breast surgery at Advocate Health Care, knows that when it comes to mammograms, breast procedures or surgery, you may have questions about the various terminology used.

To help you out, Patel answers the top seven common terms she is often asked to explain:

Screening mammograms

These are ordered for annual routine breast screenings and are a preventive measure for those with no concerns or symptoms at the time of the mammogram. Screening mammograms are important in the early detection of breast cancer.

Diagnostic mammograms

This type of mammogram is ordered when someone is having new symptoms, such as breast pain, a new lump, breast dimpling or nipple changes, that warrant further investigation via imaging.

“If there happens to be a questionable finding on a screening mammogram, the radiologist may recommend a follow-up diagnostic mammogram,” says Patel. “This mammogram will specifically focus on the area of concern and provide more details.”

3D mammograms

This imaging technique uses x-ray to give a three-dimensional view of the breast. It gives off slightly more radiation than a 2D mammogram, but it’s more accurate.

Dense breast tissue

This describes the appearance of certain tissue on a mammogram. People with dense breast tissue have a higher ratio of glandular and fibrous tissue versus fatty tissue. And it’s far from uncommon. About 50% of women in the U.S. have dense breast tissue.

Dense breast tissue categories

When you have a mammogram, your breasts are measured for density and placed into one of four categories: Category A, B, C or D. People with Category A or B breast density do not have dense breasts. They have a higher ratio of fatty tissue versus dense breast tissue. People with Category C density have dense breast tissue and those with Category D have extremely dense breast tissue.

Dense breast mammogram and ultrasound screening

There’s a chance that a mammogram may miss breast cancer in a person with dense breast tissue. In many cases, additional screening tests are ordered to help “see” through dense breast tissue to increase sensitivity in cancer detection. Breast ultrasounds and breast MRIs are noninvasive imaging that are better at seeing through dense breast tissue to detect abnormal findings. Not everyone can tolerate an MRI, so there are alternatives, such as molecular breast imaging (MBI) or contrast-enhanced mammography.

“Regardless of what supplemental options you use, it is still important to undergo your annual screening mammogram,” says Patel. “Even with dense breast tissue, mammograms can pick up other findings that ultrasounds or MRIs may not.”

Types of breast cysts

After a mammogram, ultrasound, or MRI, you might learn or see on your imaging results that you have one or more cysts. However, knowing the difference between each cyst type can help lessen your concern.

• Simple breast cyst: These cysts are benign, or non-cancerous, fluid-filled sacs in the breasts. This is especially common among premenopausal women, women 30-50 years old. Generally, these cysts don’t require intervention or treatment as they do not turn into cancer. If these cysts cause pain or tenderness, the fluid can be removed through an easy in-office procedure.
• Complicated breast cyst: These cysts may have other contents in them besides fluid, there is no solid component to them, and the risk of malignancy or cancerous cells is rare.
• Complex breast cyst: These cysts have a solid component to them. The risk of malignancy varies. Providers may order follow-up diagnostic imaging or even possibly a biopsy.

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