Mammography remains the gold standard in breast cancer screening, but it is not magic. While mammograms reveal important visual clues about breast tissue, they cannot always provide a definitive diagnosis. That is why radiologists rely on specific image features, follow-up imaging, and additional tools to distinguish between benign and suspicious findings.
We asked Dr. Tchaiko Parris, MD, PhD, Director of Mammography and Breast Cancer Prevention at ImageONE, to explain how mammograms are interpreted and what clinicians can do to support clearer, more confident readings.
How Radiologists Interpret a Mammogram
Dr. Parris explains that the shape, margin, and density of a mass are the most telling features radiologists assess on a mammogram. These are categorized using the ACR BI-RADS system:
- Shape: round, oval, or irregular
- Margins: circumscribed, obscured, indistinct, spiculated, or microlobulated
- Density: fat-containing, low, equal, or high density
Masses that are round or oval with well-defined borders are usually benign," Dr. Parris says. "Irregular shapes and spiculated margins raise red flags for malignancy."
Other signs, such as architectural distortion, asymmetries, or suspicious calcifications, can also indicate the need for further evaluation.
Why It Is Not Always Clear-Cut
Even with high-quality images, some findings remain indeterminate. When a radiologist cannot confidently determine if a mass is benign, they may recommend:
- Additional mammographic views
- Ultrasound or MRI
- Biopsy
- Short-term follow up imaging
"Imaging shows us how something looks, but not always how it behaves," Dr. Parris explains. "We use a combination of pattern recognition, risk factors, and guidelines to make the best next step decisions."
How Technologists Support Clearer Imaging
Technologists play a critical role in ensuring the mammogram is both accurate and comfortable. The right positioning and tools can make a difference in image quality and in a patient’s willingness to return for future screening.
Bella Blankets®: A Simple Solution for Better Imaging
Bella Blankets protective coverlets® improve both patient comfort and image clarity. By providing a soft barrier between the breast and the receptor plate, they help reduce discomfort and limit patient movement during compression. Bella Blankets also gently grip the skin, allowing better tissue acquisition and improved positioning.
"When patients are more comfortable, they move less," Dr. Parris notes. "That means fewer artifacts, better images, and less need for repeat exams."
TomoSPOT® Skin Markers: Clear Communication on the Image
Skin features like moles, scars, or palpable lumps can be misinterpreted unless clearly marked. TomoSPOT® skin markers for digital breast tomosynthesis provide visual references that help radiologists distinguish surface findings from internal pathology.
"Accurate marking saves time, reduces uncertainty, and prevents unnecessary callbacks," says Dr. Parris. "It also shows patients that what they feel has been acknowledged."
The Bottom Line
Mammograms provide powerful insight, but they are only as effective as the clarity of the image and the context in which it is read. That is why a collaborative approach between the technologist, radiologist, and patient is essential to successful outcomes.
When technologists use tools like Bella Blankets® and TomoSPOT®, they are not just supporting the radiologist; they are improving the overall quality of care.
Bella Blankets® protective coverlets promote better positioning and patient comfort, while TomoSPOT® skin markers for digital breast tomosynthesis ensure clear communication of skin landmarks, both of which lead to greater diagnostic confidence and fewer repeat exams.
These seemingly small touches can have a lasting impact, helping patients feel more at ease, improving the quality of the images obtained, and ultimately leading to earlier and more accurate detection of abnormalities. In breast imaging, where early detection is critical, every detail counts.
Megan Sargalski
Marketing Communications Specialist
