It must be emphasized that without proper and high-quality imaging, the ability to make an accurate interpretation is greatly reduced. After proper placement of the mammograms on the view box and following a systematic approach to viewing the mammogram, the task of mammography interpretation proceeds via a two-step process. In the first step, the object is to detect a solitary geographic area of the breast that will often appear different from other areas of the same and opposing breast. Once an area of the breast can be isolated as being a potential solitary geographic abnormality, the second step involves a determination of whether the morphological features of this area have the appearance of a "normal variation" or benign process. If the solitary geographic abnormality cannot be determined as a "normal variation," then the abnormality is classified as "suspicious" and will require further investigations. Depending on the morphological features of a"suspicious" abnormality, there is a range of probabilities that indicate the likelihood of malignancy.

Familiary with what may constitute as a "normal breast pattern" is important in interpretation of a mammogram. A "suspicious" solitary geographic abnormality, on the other hand, generally falls within three broad categories: (1) Asymmetric density; (2) Masses (including architectural distortion); and (3) Calcifications. Masses found within a mammogram often will have distinguishing shape, size, and margin characteristics. Likewise, calcifications can be characterized by their size, number, morphology, distribution, and heterogeneity. These distinguishing characteristics are the basis upon which the interpretation of a mammogram may be classified as benign or possibly malignant.

It must be noted here that the interpreter's job is not to diagnose cancer (i.e. to differentiate benign from malignant). The interpreter's job is to make a finding of whether the mammographic image presents a disruption in the "normal breast pattern" and whether such a disruption may present itself as an abnormal process which requires further investigations. The several subsections of this tutorial present an introduction to the mammographic appearance of normal and abnormal breast tissues. Follow the links below to go to each subsections: