The results of the breast screening tests are called BIRADS. BI-RADS 0 means that the population screening X-rays do not provide enough information for a final result. The radiologists cannot exactly determine what is visible in the image. Further examination is needed. That is why you will be referred to the radiology department in a hospital for further assessment. At the hospital, the radiologist will take additional X-rays or perform an ultrasound scan. This page tells you about the potential causes of any abnormalities in the image.

What can the abnormalities in the breast X-ray mean?

9 out of 10 women who undergo further assessment do not have breast cancer. There are several causes that may indicate abnormalities in the image. These are benign and cannot become malignant. They are not signs of breast cancer.  

Possible causes for abnormalities in the image are:

Cyst

One of the most common benign abnormalities in the breast is a fluid sac. Another name is a cyst. A cyst can be caused by a blockage of a milk gland duct. There may be multiple cysts in one or both breasts. A cyst does not require treatment. It can also disappear by itself. Sometimes a physician may drain the fluid from a cyst with an injection needle. They only do this if the radiologist wants to make sure it is in fact a fluid sac.

Fibrous lump

Sometimes a benign lump, or nodule, in the breast’s connective tissue causes an abnormality on the X-ray. This is the most common type of benign breast nodule. Another name for this lump is fibroadenoma. Fibroadenomas are most common in women under 35. Older women can also have fibroadenomas. To properly examine whether the lump is benign, the laboratory will have to examine the breast tissue. The radiologist will remove a tiny piece of breast tissue. This is usually done under local anaesthetic. It is called a biopsy.

Lymph node

Lymph nodes are mainly located in the armpit but can also be in the breast. On a mammogram, they look like a small spot. An ultrasound scan can be used to determine if the lymph node is benign.

Distortion of breast tissue

Sometimes the physician sees a change in the milk gland tissue on the X-rays. This may be because you have had surgery or a breast infection at some time. Another name is architectural distortion.

By taking additional X-rays and an ultrasound, the physician can usually determine that there is no evidence of breast cancer. In some cases, an additional breast examination is required, through an MRI scan or laboratory tests on the breast tissue. The radiologist will remove a tiny piece of breast tissue. This is usually done under local anaesthetic. It is called a biopsy.

A difference between the left and right breast

When there is a difference between the left and right breast, the glandular tissue in one of the breasts looks different. This is also called asymmetry. Additional examination is required to determine if these breasts contain normal breast tissue. This could mean an additional X-ray or an ultrasound scan. If the physician still has doubts, they may order an MRI scan for additional examination. Sometimes the physician wants the laboratory to examine the breast tissue. The radiologist will remove a tiny piece of breast tissue. This is usually done under local anaesthetic. It is called a biopsy.

Unchanged image on the X-ray

You may be referred to the hospital for further examination due to one of the reasons listed above. Sometimes the abnormality was already visible in old X-rays taken at the hospital and nothing has changed. In that case, the physician knows that what is visible on the breast X-ray is benign.