With the implementation of the Affordable Care Act, patients now have access to their electronic medical record, which includes a mammography report for anyone having a mammogram.
Patients who have had a mammogram are familiar with the simple terms that a "results" letter is written in, but they may encounter unfamiliar terminology when reading a mammography report. This report is sent to the patient's referring physician.
The most important part of the report is the "Findings" section, where the radiologist describes what he or she saw on the mammogram.
The first statement is usually in reference to the density of the patient's breasts. Reporting the density is meant to indicate how easy the mammogram was to interpret. Cancers can be harder to detect in denser tissue.
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Abnormalities that can be seen on the mammogram are masses, calcifications, asymmetries and architectural distortion. A radiologist may describe the appearance of a suspicious mass using terms such as "spiculated," "ill-defined" or "irregular."
Calcifications — small, white spots on the mammogram — are common and most are benign, but calcifications can be associated with cancer. Terms used to describe calcifications often seen in malignancies are "linear," "branching" or "heterogeneous."
Architectural distortion is a special finding in which the tissue appears puckered or pulled in and can indicate an underlying malignancy. An asymmetry is simply a density on the mammogram that stands out, especially in comparison to the other side, or is new in comparison to a previous mammogram. These often are benign, but are a common cause for patients to return for additional views.
The report will end with the overall impression and recommendation. The patient will be assigned a Breast Imaging and Reporting Data System (BI-RADs) category. This number indicates the radiologist's overall impression. Categories are from 0 to 5 and their meanings are:
Category 0 — The exam is incomplete.
Category 1 — A negative mammogram. In this case, "negative" is good because it means there are no significant abnormalities.
Category 2 — A benign finding on the mammogram.
Category 3 — A finding on the mammogram that is felt to be probably benign and a short interval follow-up is recommended (usually in 6 months)
Categories 4 and 5 — A biopsy is recommended.
Category 5 — The finding is highly suggestive of malignancy.
While the mammography report is available to patients in their electronic medical records, the U.S. Food and Drug Administration still requires that patients receive a "results" letter or some other type of notification of their mammogram results.