Regular mammograms are an important part of breast health. It’s good to be familiar with how the images look in case a healthcare provider shows one to you.Amammogramimage has a black background and shows the breast in variations of gray and white. In general, the denser the tissue, the whiter it appears. This may include normal tissue and glands, as well as areas ofbenign (noncancerous) breast changes(such asfibroadenomas) and disease (breast cancer). Fat and other less-dense tissue look gray on a mammogram image.Mammograms look different for each person: What matters most is what’s normal for you. If you have dense breasts, your mammograms will have more white, and the radiologist will read them accordingly, watching for changes.Read on to see some images of what mammograms may look like, and what reports you might read.What Is a Mammogram?
Regular mammograms are an important part of breast health. It’s good to be familiar with how the images look in case a healthcare provider shows one to you.
Amammogramimage has a black background and shows the breast in variations of gray and white. In general, the denser the tissue, the whiter it appears. This may include normal tissue and glands, as well as areas ofbenign (noncancerous) breast changes(such asfibroadenomas) and disease (breast cancer). Fat and other less-dense tissue look gray on a mammogram image.
Mammograms look different for each person: What matters most is what’s normal for you. If you have dense breasts, your mammograms will have more white, and the radiologist will read them accordingly, watching for changes.
Read on to see some images of what mammograms may look like, and what reports you might read.
What Is a Mammogram?
Normal Breast TissueNational Cancer InstituteThis image is a mammogram of a normal fatty breast, typical of older women, that does not have a lot of dense tissue. A mammogram searching for abnormal lesions, benign lumps, or breast cancer is more accurate when performed on women with non-dense breasts such as these.The gray areas correspond to normal fatty tissue, while the white areas are normal breast tissue with ducts and lobes. Whilebreast massesalso appear white on a mammogram, their color is typically more concentrated because they are denser than other features of a normal breast, like those seen here.Most women will have their first mammogram at age 40 to 50, and this can serve as a good baseline from which to compare your images in the future. Women withbreast cancer risk factorsmay start screening earlier.Having a baseline mammogram, regardless of the frequency of your mammograms, is helpful in establishing what normal looks like for you. Over time, a woman’s breasts can change. This can happen after childbirth, following abreast biopsy, or with breast implants. It is not uncommon to getbenign lumps, cysts, masses, calcifications, or denser tissue.
Normal Breast Tissue
National Cancer Institute
This image is a mammogram of a normal fatty breast, typical of older women, that does not have a lot of dense tissue. A mammogram searching for abnormal lesions, benign lumps, or breast cancer is more accurate when performed on women with non-dense breasts such as these.
The gray areas correspond to normal fatty tissue, while the white areas are normal breast tissue with ducts and lobes. Whilebreast massesalso appear white on a mammogram, their color is typically more concentrated because they are denser than other features of a normal breast, like those seen here.
Most women will have their first mammogram at age 40 to 50, and this can serve as a good baseline from which to compare your images in the future. Women withbreast cancer risk factorsmay start screening earlier.
Having a baseline mammogram, regardless of the frequency of your mammograms, is helpful in establishing what normal looks like for you. Over time, a woman’s breasts can change. This can happen after childbirth, following abreast biopsy, or with breast implants. It is not uncommon to getbenign lumps, cysts, masses, calcifications, or denser tissue.
Normal Dense Breast TissueNational Cancer InstituteThis image shows two mammograms of normal, dense breasts. As with the first image, the dark areas are fatty tissue, and the light areas are denser tissue that contains ducts, lobes, and other features. Compare these images and you can see the differences in density in what are both normal breasts.Young women, especially those who have not had children, usually have dense and rather firm breast tissue. Mammogram images like these can be difficult for a radiologist to read because there is less differentiation between normal and possibly abnormal tissue, potentially hiding areas that need closer study.Mammography equipment can be adjusted to image dense breasts, but that may not be enough to solve the problem. If a particular area needs a better image, abreast ultrasoundis usually the next step. Abreast MRI (magnetic resonance imaging) may be recommended for young women with a strongfamily historyof breast cancer or those known to havegenetic mutationsthat increase risk (see below).Dense breasts are identified as such based on their appearance on a mammogram—not what they feel like. Having dense breasts is not abnormal. It just means you have less fat in your breasts than is typical. However, women with dense breasts do have a slightly higher risk of developing breast cancer.
Normal Dense Breast Tissue
This image shows two mammograms of normal, dense breasts. As with the first image, the dark areas are fatty tissue, and the light areas are denser tissue that contains ducts, lobes, and other features. Compare these images and you can see the differences in density in what are both normal breasts.
Young women, especially those who have not had children, usually have dense and rather firm breast tissue. Mammogram images like these can be difficult for a radiologist to read because there is less differentiation between normal and possibly abnormal tissue, potentially hiding areas that need closer study.
Mammography equipment can be adjusted to image dense breasts, but that may not be enough to solve the problem. If a particular area needs a better image, abreast ultrasoundis usually the next step. Abreast MRI (magnetic resonance imaging) may be recommended for young women with a strongfamily historyof breast cancer or those known to havegenetic mutationsthat increase risk (see below).
Dense breasts are identified as such based on their appearance on a mammogram—not what they feel like. Having dense breasts is not abnormal. It just means you have less fat in your breasts than is typical. However, women with dense breasts do have a slightly higher risk of developing breast cancer.
Breast CalcificationsNational Cancer InstituteHere, the lighter white areas show denser tissues, but the more concentrated white spots arecalcifications. These are tiny bits of calcium that may show up in clusters or in patterns (like circles) along the milk ducts.Calcifications are associated with extra cell activity in breast tissue. Usually, the extra cell growth is not cancerous. Sometimes, however, tight clusters of microcalcifications (small calcifications) can be an early warning sign of precancerous cells.Scattered microcalcifications are usually a sign ofbenign breast tissue.The pattern and shape of microcalcifications can also give radiologists clues about whether cancer may be present. Fine, linear calcifications raise suspicion of underlying breast cancer, whereas popcorn, eggshell, and rim-like calcifications are usually benign.In this mammogram image, the breast calcifications are in ductal patterns. This is considered an abnormal mammogram, but it’s not necessarily one that indicates cancer. In this case, the woman was advised to have a follow-up mammogram in three months for comparison. If the woman had a lump associated with these calcifications, immediate further testing would have been needed.Macrocalcifications (large calcifications) are larger bits of calcium due to the normal process of aging in the breasts. They are found in roughly half of women over the age of 50, and unlike microcalcifications, are not usually a sign of cancer.
Breast Calcifications
Here, the lighter white areas show denser tissues, but the more concentrated white spots arecalcifications. These are tiny bits of calcium that may show up in clusters or in patterns (like circles) along the milk ducts.
Calcifications are associated with extra cell activity in breast tissue. Usually, the extra cell growth is not cancerous. Sometimes, however, tight clusters of microcalcifications (small calcifications) can be an early warning sign of precancerous cells.Scattered microcalcifications are usually a sign ofbenign breast tissue.
The pattern and shape of microcalcifications can also give radiologists clues about whether cancer may be present. Fine, linear calcifications raise suspicion of underlying breast cancer, whereas popcorn, eggshell, and rim-like calcifications are usually benign.
In this mammogram image, the breast calcifications are in ductal patterns. This is considered an abnormal mammogram, but it’s not necessarily one that indicates cancer. In this case, the woman was advised to have a follow-up mammogram in three months for comparison. If the woman had a lump associated with these calcifications, immediate further testing would have been needed.
Macrocalcifications (large calcifications) are larger bits of calcium due to the normal process of aging in the breasts. They are found in roughly half of women over the age of 50, and unlike microcalcifications, are not usually a sign of cancer.
Fibrocystic Breast Tissue
Fibroadenomasandcystsare benign breast masses that can appear in fibrocystic breast tissue. These can occur alone or in groups and show up on mammograms as a dense (white) mass.
Fibrocystic changes in the breast are usually not a sign of disease and do not require treatment. These changes can sometimes causebreast painand lumpiness, so if this becomes concerning, see your healthcare provider.
If an abnormality is thought to be a cyst, a breast ultrasound is usually done to confirm that it is a cyst rather than a solid nodule. If a breast cyst is causing symptoms, a radiologist can use ultrasound guidance to place a needle in the cyst and drain it.
Breast Tumor
ksass / Getty Images
As with the others, this mammogram shows both normal fatty tissue (dark) and lighter areas of denser breast tissue. What’s concerning here is the whitest area on the bottom right, which shows acancerous (cancerous) tumor.
A cancerous tumor in the breast is composed of a mass ofcancer cellsthat are growing in an abnormal, uncontrolled way. The tumor may invade surrounding tissue, or it may shed cells into the bloodstream or lymph system. If the tumor cells migrate beyond the original site and spread to other parts of the body, it is consideredmetastatic breast cancer.
It’s important to note that even if a change looks very much like cancer on a mammogram, there are somebenign breast changes that mimic breast cancer. When this occurs, further imaging—and most often, a biopsy (removing a sample of tissue for examination in a lab)—are necessary to know whether it is truly cancer or not.
Likewise, a mammogram may appear normal even if cancer is present. Roughly 20% of breast cancers are not seen on a screening mammogram, and this number may be higher for women who have very dense breasts.In addition, some types of breast cancer, such asinflammatory breast cancerandPaget’s disease of the breast, do not usually result in a mass and can easily be overlooked on a mammogram.
How Breast Cancer Is Treated
Breast ImplantPam StephanThis mammogram shows two views of a breast following a mastectomy and reconstruction with a silicone breast implant. (Mammograms can be performed on breast implantsif less compression is used than what is required with natural breast tissue.) This woman had been successfully treated for a type of breast cancer calledinvasive ductal carcinoma.Inboth viewsof this breast reconstruction, the implant appears as a light, smooth-sided area. This implant is inserted into a pocket of the chest wall. The chest wall muscle appears as the medium-dark area just outside the implant.Mammograms taken after a diagnosis of breast cancer are important screening tests. There is no evidence of breast cancer in these images.Note that the overhead view, called thecranial-caudalview, shows a smaller area than the diagonal view, called themediolateralview. Having these two views is very helpful for healthcare providers to determine breast health.
Breast Implant
Pam Stephan
This mammogram shows two views of a breast following a mastectomy and reconstruction with a silicone breast implant. (Mammograms can be performed on breast implantsif less compression is used than what is required with natural breast tissue.) This woman had been successfully treated for a type of breast cancer calledinvasive ductal carcinoma.
Inboth viewsof this breast reconstruction, the implant appears as a light, smooth-sided area. This implant is inserted into a pocket of the chest wall. The chest wall muscle appears as the medium-dark area just outside the implant.
Mammograms taken after a diagnosis of breast cancer are important screening tests. There is no evidence of breast cancer in these images.
Note that the overhead view, called thecranial-caudalview, shows a smaller area than the diagonal view, called themediolateralview. Having these two views is very helpful for healthcare providers to determine breast health.
Your Mammogram ReportYour mammogram report will detail the radiologist’s opinion about what they reviewed, with notes on things like calcifications or any masses.If you are unsure of what any findings mean, talk to your healthcare provider.In addition to noting any findings, you will see aBI-RADSnumber. BI-RADS stands for Breast Imaging Reporting and Data System, and the number is a classification of the likelihood your mammogram is normal or shows cancer.If you have not had a biopsy, you will be assigned a number between 0 and 5. A score of 0 indicates that the mammogram didn’t provide enough information to make a clear call. A score of 6 is given when a mass has already been found malignant.Your report will also include adescription of breast density, which will indicate if your breasts are “dense” or “not dense.”
Your Mammogram Report
Your mammogram report will detail the radiologist’s opinion about what they reviewed, with notes on things like calcifications or any masses.
If you are unsure of what any findings mean, talk to your healthcare provider.
In addition to noting any findings, you will see aBI-RADSnumber. BI-RADS stands for Breast Imaging Reporting and Data System, and the number is a classification of the likelihood your mammogram is normal or shows cancer.
If you have not had a biopsy, you will be assigned a number between 0 and 5. A score of 0 indicates that the mammogram didn’t provide enough information to make a clear call. A score of 6 is given when a mass has already been found malignant.
Your report will also include adescription of breast density, which will indicate if your breasts are “dense” or “not dense.”
Mammogram and MRI Image Comparisons
Mammograms, in addition to regular breast exams, are the primary screening tool used for breast cancer. Breast MRI is much more expensive than mammograms, and the equipment is not as widely available. For this reason, MRI technology is not used for routine breast screening.
However, breast MRI has its place. Because it can capture an image that is higher contrast and more detailed than a mammogram, it may be used for women who are at high risk for breast cancer or have dense breasts, or when a mammogram reveals an area that needs further examination. It is also often used, especially in younger women, to monitor the other breast for the development of breast cancer if a woman has had a mastectomy on one side.
Breast MRI With Contrast Uses, Risks, and Side Effects
SummaryMammogram images can be confusing, and it’s not always clear what you’re looking at. In general, dense tissue shows up white, and less dense tissue is grayer. Knowing what is normal for your breasts helps the technicians and radiologists determine what changes have occurred since your last mammogram, and if there are any new areas that need further examination.
Summary
Mammogram images can be confusing, and it’s not always clear what you’re looking at. In general, dense tissue shows up white, and less dense tissue is grayer. Knowing what is normal for your breasts helps the technicians and radiologists determine what changes have occurred since your last mammogram, and if there are any new areas that need further examination.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Cleveland Clinic.Benign breast disease: Lump in the breast.
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Bernal ACBA, Chaves GWOG, dos Santos Alves I, et al.Don’t get scared but be aware: Focal fibrocystic changes.Clin Rev Cases. 2020;2(2):1-4.
American Cancer Society.Limitations of mammograms.
U.S. Food and Drug Administration.Important Information: Final Rule to Amend the Mammography Quality Standards Act (MQSA).
American Cancer Society 2017.What Does a Doctor Look for on a Mammogram?Iwase M, Tsunoda H, Nakayama K, et al.Overcalling low-risk findings: grouped amorphous calcifications found at screening mammography associated with minimal cancer risk.Breast Cancer. 2017;24(4):579-584. doi:10.1007/s12282-016-0742-z
American Cancer Society 2017.What Does a Doctor Look for on a Mammogram?
Iwase M, Tsunoda H, Nakayama K, et al.Overcalling low-risk findings: grouped amorphous calcifications found at screening mammography associated with minimal cancer risk.Breast Cancer. 2017;24(4):579-584. doi:10.1007/s12282-016-0742-z
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