Lisa Tolnitch, MD, of Duke Cancer Institute answers questions about breast cancer.

Can calcifications in the breast turn into cancer?

Calcifications on mammography do not themselves turn into cancer. They can be a marker especially in certain patterns of an evolving cancer.

Worrisome features are pleomorphic calcifications (different sizes and shapes in a group), branching forms (following the branches of a milk duct), or casting calcifications. Those features usually require a biopsy under mammogram guidance with a core needle. 

Is a mastectomy always the best option to treat breast cancer?

Mastectomy is an option for surgical treatment. If a tumor is small, less than 4 centimeters, and does not have locally advanced features such as skin involvement, a patient can have a lumpectomy with the same survival as mastectomy. Most patients are equally good candidates for both procedures.   

What will I look like after a lumpectomy?

After a lumpectomy the breast should look very similar to how it started in shape and size. There can be some loss of contour or fullness where the tumor was and after radiation, which causes some retraction. This is variable from patient to patient as everyone heals differently.   

Does mammography really prevent cancer deaths?

Mammography can prevent cancer deaths by picking up tumors when they are small or present at an early stage. The survival rate for women who have regular screening mammograms with a diagnosis of cancer exceeds 90 percent.

Are dense breasts more at risk for breast cancer?

Dense breasts are at slightly more risk for cancer. In some states radiologists are required to give a density score on mammography.

In general, all women have dense breasts when they are young and most become fatty replaced with age.