The Auria Glossary

Benign:  A term to describe non-cancerous findings, either by biopsy or imaging. 

Biopsy:  A method for obtaining tissue or fluid to study under the microscope to identify the type of cells in tissue. 

BIRADS stands for “Breast Imaging Reporting and Data System, which is a system radiologists use to classify the findings on a mammogram or other breast imaging.  Each finding is given a BIRADS score, so each finding in a breast will have its own BIRADS score. Radiologists have done extensive research and identified features on breast imaging that help them to determine if a finding is likely to be cancer or not.  While the only certain way to determine if something is benign or cancer is through biopsy, the BIRADS system helps radiologists plan a course of action without doing excessive biopsies.

BIRADS 0 means the findings are incomplete and more imaging is needed to complete the evaluation.  This is the typical rating used when a screening mammogram is done and a “call back” is necessary to complete the study. 

BIRADS 1 means there are no significant findings. 

BIRADS 2 means there is a finding that has been found to be insignificant.  For instance, a cyst or fibroadenoma may be present, but studies have found them to be benign. 

BIRADS 3 means there is a finding with some features that are concerning, but there is a less than 2% chance it is malignant.  Since breast cancer typically grows slowly, the radiologist will want to do studies over time to see if the finding changes.  Follow up studies typically are done 6 months, 1 year, sometimes at 18 months and again 2 years after the original finding.  If there are no changes in the finding, women are usually put back into the routine screening schedule.  Note that at the 1 and 2 year marks, both breasts are imaged to be sure the unaffected breast is screened annually. 

BIRADS 4 means there are significant features that warrant a biopsy to rule out malignancy. 

BIRADS 5 means the features are significant enough that the finding is likely malignant. 

BIRADS 6 means the finding has been biopsy proven to be malignant.

Breast calcifications are calcium deposits within breast tissue. They appear as white spots or flecks on a mammogram and indicate cellular change. Breast calcifications are common on mammograms, and they're especially prevalent after age 50. Most breast calcifications are benign (not cancer), though any new or changing calcium deposits should be evaluated as they can sometimes be associated with one of the earliest forms of breast cancer.  When new calcifications appear in a mammogram they are usually followed with long-term follow-up or biopsy.  

Breast cysts: A fluid-filled sac in breast tissue.  Cysts are usually benign, however, they can be uncomfortable, especially just before the menstrual period.  You may have one or multiple breast cysts.  Most radiologists agree that cysts that are not uncomfortable should not be drained as any puncture with a needle can lead to infection.  If they are uncomfortable, local anesthesia is given and ultrasound is used to guide a small needle into the cyst.  Because cysts are rarely cancer, the radiologist usually does not send it to the pathology for analysis.  If the fluid in the cyst is bloody or pus-like it will usually be sent for analysis.   

Breast density is a term that describes the relative amount of the different types of breast tissue as seen on a mammogram. Dense breasts have relatively high amounts of glandular tissue and fibrous connective tissue and relatively low amounts of fatty breast tissue.

A breast MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the breast and surrounding tissue. It does not use radiation (x-rays). A breast MRI may be done in combination with mammography or ultrasound. It is not a replacement for mammography. It is often used as a supplemental screening tool for women who are high risk for developing breast cancer in their lifetime or when there is a known breast change needing evaluation.

Breast tissue is the milk glands, milk ducts, supportive tissue, and fatty tissue that make up the breasts.  

A diagnostic mammogram is done when there is a symptom (lump, unresolved pain or discharge, skin changes, etc.) or when something has been noted on a previous mammogram that needs to be watched over time.  It is important to follow the recommendations of the radiologist and have diagnostic mammograms until the area of concern has been cleared as "normal" before resuming screening mammograms. Breast cancers usually grow slowly. Imaging the area of concern using diagnostic mammograms, which use magnification and different angles, helps to assess if the area has changed over time.  Ultrasound and other imaging may also be done to assess the area.  Most insurance covers diagnostic breast imaging, but will also require you to pay a deductible before insurance pays for the studies.

Fatty-replaced breast tissue is a term used in mammography that refers to the replacement of breast tissue with fatty tissue. This commonly occurs as a woman ages. 

Fibroadenomas are common benign (not cancerous)  tumors of the breast. They are made up of an overgrowth of both the glandular and supporting tissues of the breast.

Having fibrocystic breast tissue is a common, benign (noncancerous) condition that affects more than half of women at some point in their lives. Fibrocystic breasts occur due to swelling of the glandular tissues of the breasts caused by changes in the menstrual cycle hormones (estrogen and progesterone). It is not the same as having dense breasts.

Together, fibrous and glandular tissue are called fibroglandular tissue. Fatty tissue fills the space between the fibrous tissue, lobes, and ducts. 

Glandular tissue is the part of the breast that makes milk, called the lobes.

Insurance coverage:  With some exceptions, insurance typically pays 100% of a screening mammogram (one that is done annually when no problems have been identified).  Diagnostic studies are usually “covered” by insurance, but often the deductible needs to be met before insurance pays for the study.  If the deductible has not been fully met, patients can expect to pay out of pocket for follow up studies to a screening mammogram.  Follow up studies are also referred to as “diagnostic” studies.

Malignant (malignancy):  Biopsy proven cancer.

The tubes that carry milk to the nipple are called milk ducts.

A term used to describe breast tissue that is made up of mostly fatty tissue and also has some patches of dense fibrous tissue and glandular tissue. 

A screening mammogram is done when you have no symptoms (lump, unresolved pain or discharge, skin changes, etc.).  Many refer to this mammogram as the "annual mammogram."  Insurance usually pays for this with no out-of-pocket cost to the patient.