Screening Mammogram vs. Diagnostic Mammogram: What’s the Difference?
Understanding the difference between a screening vs diagnostic mammogram is an important step in taking charge of your breast health. While both exams use imaging to keep you healthy, your medical team will recommend one over the other depending on your symptoms, medical history, and previous test results.
What is a Screening Mammogram?
If you are getting a screening mammogram, expect an X-ray image at low radiation dose.
The Purpose of Routine Breast Cancer Screening
This screen is designed to show early signs of breast cancer in individuals who might not be experiencing any symptoms.
Who Typically Receives a Screening Mammogram
In most cases, these screenings are performed on women aged 40, who undergo them each year.
What is a Diagnostic Mammogram?
If you’re scheduled for a diagnostic mammogram, then you’ll experience a more in-depth X-ray exam.
Why Diagnostic Imaging May Be Recommended
These are usually recommended after a screening mammogram to evaluate a specific area of the breast that needs to be ruled out as a concern.
Symptoms or Findings That May Require Further Investigation
A diagnostic screening is meant to look at lumps that were detected or other areas that may not be clear on the screening x-ray.
Screening vs. Diagnostic Mammogram: Key Differences
There are differences that you can expect between these two images, including their purposes, the type of images, how many images they take, and the review process of each mammogram.
Purpose of the Exam
The purpose of the two exams does differ. The screening mammogram is the initial step to detect signs. This is treated as a routine screening. The diagnostic mammogram’s purpose is to look at a certain area (s) more closely after the initial screening mammogram. Understanding the purpose of a screening vs diagnostic mammogram helps alleviate appointment anxiety.
Number and Types of Images
In the initial screening mammogram, there are four images, two of each breast. They are meant to capture all angles. In a diagnostic mammogram, however, there are more images, and the radiologist requests a specific number based on what was found in the initial screening.
The types of images are also more localized, enlarging areas of concern. In a screening mammogram, these images are the baseline 2D or 3D images of the breast tissue.
How the Imaging is Reviewed
Once these images are taken, they are reviewed by a radiologist to determine whether further testing or referrals are needed or if the patient is healthy. General radiologists usually review the screening mammograms. In some cases, the diagnostic mammogram will be reviewed by radiologists who specialize in breast tissue.
Why Might You Need a Diagnostic Mammogram?
After getting a screening mammogram, you may be notified that you need another exam, the diagnostic mammogram, due to something unusual on the screening.
A Lump or Other Breast Change
One of the most common reasons for a diagnostic mammogram is a new lump. Other breast changes, such as nipple changes or non-milk discharge, could require a diagnostic mammogram.
A Finding on a Screening Mammogram
If the results of your screening mammogram were abnormal, a diagnostic mammogram will often be recommended to further evaluate any mass or clustered or distorted areas that may have appeared.
Follow-Up of a Previous Imaging Finding
If you’ve been monitoring a mass or lump, you can expect to continue that monitoring with a follow-up diagnostic mammogram. This will continue to monitor growth and check for any changes in the cells and their sizes.
What Happens During a Diagnostic Mammogram
The diagnostic mammogram lasts about 30 minutes and requires you to undress from the waist up. Expect to stand for the duration of the exam, with a tech assisting you with positioning and breast compression during this mammogram.
Additional or Specialized Mammogram Views
Because there is usually a specific area that is being targeted, you can expect to stand in some position longer than others, especially if the focus is more on one breast than the other. Expect to wait a few minutes after the images have been taken to see if the radiologist needs additional images after reviewing.
When Breast Ultrasound May Also Be Used
In some cases, based on what is seen or unable to be reached on the x-ray, the radiologist may require you to have a breast ultrasound during your visit. In this case, you’ll have to lie back. At the same time, a tech uses the ultrasound wand to get additional images for the radiologist.
Does Being Called Back Mean You Have Breast Cancer?
Getting a call back from the radiologist does not automatically mean that you have cancer; it just indicates that some abnormalities need to be addressed. Many patients wonder how a screening vs diagnostic mammogram impacts their health outlook, but additional imaging is standard and common.
Common Reasons Patients are Called Back
Some of the most common reasons for a callback are unclear images during the screening mammogram. This means they need to take additional images to make sure a spot just appeared due to breast placement.
Other reasons to get a call back would be because you have dense breast tissue, and that can make the standard screening mammogram harder to read. In these cases, a diagnostic mammogram is required to move forward.
Why Additional Imaging is Often Precautionary
Sometimes harmless cysts develop, and additional imaging allows your medical team to determine whether they are benign or cause concern. They also help determine whether a spot seen on the initial screening is even a spot at all.
Can You Schedule a Screening Mammogram if You Have Symptoms?
Absolutely, if you are experiencing symptoms that have you concerned about your breast health, then you can schedule a screening mammogram to see if there are any abnormalities.
Why Patients Should Report Breast Changes
In a lot of cases, breast cancer goes unnoticed for a while. Even the smallest change can make a difference in detection and treatment options. Changes that you are looking for include the following:
- Nipple Issues/Changes
- Size and shape of breasts
- Lumps
- Changes in your skin texture and color
- Pain that tends to linger
Determining the Appropriate Type of Imaging
Based on the symptoms you are experiencing, your team may schedule you first for a screening mammogram to help identify the target areas. They may also require a diagnostic mammogram later for more detailed images.
Getting the Right Breast Imaging for Your Needs
It’s important to know whether a screening vs diagnostic mammogram is right for you. It should be based on how you are feeling and/or whether you are having a screening mammogram. If you have symptoms, inform your medical team that you want more detailed imaging, including breast exams if necessary.
At Women’s Imaging Specialists, we look forward to helping you schedule your routine mammogram. If you aren’t sure which imaging option is right for you, contact us today, and we’ll be happy to answer all your questions.
