Why are margin characteristics important when evaluating a mammographic mass?

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Margin characteristics are how we judge how a mass interacts with surrounding tissue. Malignant lesions commonly show edges that are spiculated or ill-defined because cancer cells invade adjacent structures and elicit a tissue reaction, producing irregular, radiating lines. Benign lesions, like many fibroadenomas or simple cysts, tend to have smooth, well-circumscribed borders. This difference in edge appearance helps estimate the likelihood of cancer and informs the next steps in management, often alongside density, calcifications, and clinical context. Color on the image, the patient’s age, or calcifications by themselves aren’t determined by the margins, and margins don’t dictate the presence of calcifications.