A Mammogram is the only exam to show early stage Breast Cancer. Other exams such as Ultrasound, Nuclear Medicine and MRI are done after a Breast Mass is found.

Let's say you were 'called back' after your Mammogram for micro-calcifications. The additional views appear suspicious. What's next? One of two things will happen.

1) Needle Biopsy (Stereo Tactic Core Biopsy)
2) Needle localization followed by surgery

Stereo Tactic Core Biopsy (that's what I had!) is done by a Radiologist in the Mammography Department. You lie on your stomach on a table with a hole in it. The hole is where your breast goes! All the work is done under the table.They numb your breast, and the needle captures the calcifications and removes them from your breast. A Pathologist will test the tissue for malignancy.

Needle Localization is also done by a Radiologist in the Mammography Department. You can stand or sit during this procedure.They numb your breast, and a needle is placed to localize the calcification area. You will then go to surgery and a Surgeon will remove the tissue around the needle. The tissue is sent back to the Mammography Department and imaged. This ensures the suspicious area is removed.

A breast mass that can be felt doesn't require any localization procedures. The surgeon can remove it easily.

I'm sure you've heard of stories where a woman had a Mammogram and 6 months later she had full blown Breast Cancer. One of the reasons for this is she might have been pre-menapausal and her hormones accelerated the growth. This is a very aggressive type of breast cancer.

My worst case that still makes me cry is a 32 y/o pregnant woman who developed a breast mass. I imaged her breasts (shielding her pregnant tummy with a lead apron) and she had a biopsy. It was malignant and 5 months later she had to abort her baby and she died.Her pregnancy hormones fed the cancer and it spread quickly. That will stay with me for the rest of my life.

What happens if your biopsy is positive (malignant)? Your choices are:

1) Lumpectomy (remove mass area only) with Radiation Therapy and possible Chemo Therapy.
You will have close Mammographic follow ups for several years.
2) Radical Mastectomy (remove entire breast and axillary lymph nodes). The lymph nodes are tested for malignancy. These results will determine your Radiation and/or Chemo treatments.
You will have close follow ups of your remaining breast.

If your biopsy is negative (benign) you will have a 6 month follow up of the affected breast, if all's well you will return to your normal Mammography schedule.

Breast Cancer is not for women only. In my career I've seen several men with Breast Cancer. They had mastectomies and a Mammogram of the remaining breast yearly. Men don't know to examine themselves. In most cases their wives found the lump and sent them to the Doctor!

One man I remember was a nice big guy. When I compressed his breast he offered to help. He pushed the compression paddle down himself! On his way out he fixed our squeaky door!!
He was a hoot!