Tests

[Barks]

A few weeks ago my wife found a small lump in her left breast and had a mammogram. The mammogram was inconclusive and wasas followed by another mammogram and ultrasound. A biopsy was recommended. The procedure was taken some time and when my wife inquired she was told that locating the microcalicifaction was difficult. My wife said what about the lump under my nipple. The surgeon responded that she would also biopsy this area. The diagnosis was non-invasice cancer in the micro-calcification and invasive cancer in the small lump under her nipple. My question is how could a mammogram and an ultrasound pick up microcalcifications but not pick up a cancerous tumor.

[CCF-RN,MSN-rf]

Dear Barks:  Mammography is not a perfect test but it is the best we have at present.  This is why we say that a mammogram alone is not enough when it comes to screening for cancer.  A mammogram should also be accompanied by a clinical breast examination by a physician and monthly self-breast examination.

[surgeon]

calcifications show as white dots and are easy to see on mammogram: ultrasound usually doesn't find them. Neither can tell what the calcifications are due to; only biopsy can do that. Mammogram may or may not see every lump which is feelable; it depends on various characteristics, including how dense the breast tissue is in the area, what pattern of shadows are cast by the lump. That's why it's a cardinal error if a woman has a lump, and a mammogram is ok, so no further plans are made for followup.