The Difference Between Diagnostic and Screening Mammograms

Do you know the difference between a screening and a diagnostic mammogram?

Most women over 40 are familiar with annual screening mammograms. They are a type of screening done to detect breast cancer. Diagnostic mammograms, on the other hand, help to diagnose and treat breast cancer. They can also help track follow-up after treatment or as part of a clinical trial.

It may not be easy to tell the difference between screening and diagnostic mammograms. But, it’s helpful to understand the differences before scheduling an appointment.

What are Screening Mammograms?

Screening mammograms are a type of X-ray image done to find unusual tissue in the breast. These tests are for people who have an average risk of disease and who have no symptoms.

Women should begin annual screening at age 40. The screenings should continue as long as one is healthy enough to have cancer treatments if needed. Your doctor may recommend that you begin screening at a younger age if you are at high risk for breast cancer.

One in eight American women will develop invasive breast cancer during her lifetime. That makes getting an annual mammogram one of the most important things you can do for breast health. Mammograms help detect cancers early when they’re much more treatable. These screenings can spare women from painful surgery, unpleasant treatments, or even death.

What are Diagnostic Mammograms?

A diagnostic mammogram helps radiologists make an accurate diagnosis. For example, they help determine if symptoms are indicative of the presence of cancer. Diagnostic mammograms show more details of the breast compared to screening mammograms.

Diagnostic mammograms use specialized techniques like localized imaging and view magnifications. They also provide more information if a woman has breast cancer.

Why would I need a diagnostic mammogram?

Your doctor might order a diagnostic mammogram if your screening returned “abnormal” results. They are also ordered if you have symptoms or unusual breast changes.

Symptoms looked at by diagnostic imaging include things like lumps, pain, or discharge. Changes in breast size, shape, or skin thickness may also need diagnostic testing.

Women who have (or had) breast cancer and women with breast implants also may need diagnostic imaging. Being open with your doctor will help them order the correct exam for you.

What is an “Abnormal” Mammogram?

The word “abnormal” may sound like a cause for concern. However, an abnormal mammogram means results are different from other women of the same age.

An “abnormality” could be due to benign conditions. These include things like natural dense breast tissue, a cyst, or a non-cancerous tumor. In some cases, images from the screening are distorted and show inaccurate results.

We perform 3D mammograms at Premier Diagnostic Imaging. 3D mammograms are more accurate than traditional 2D mammograms. They reduce callbacks by 40% and finding 20-65% more invasive breast cancer.

Does an Abnormal Mammogram Mean I have Cancer?

Many women who have screenings are called back for abnormal findings. That doesn’t mean you have breast cancer. In fact, according to the American Cancer Society, “fewer than 1 in 10 women called back for more tests are found to have cancer.”

Key Differences Between Diagnostic and Screening Mammograms

There are a few key differences between the two types of mammograms:

  • Purpose: Screening mammograms help prevent advanced disease. Their goal is to catch breast cancer in early, more treatable stages. Diagnostic mammograms further examine abnormal screening results or other breast issues.
  • Who: Screening mammography is for women over 40 with average disease risk and no symptoms. Diagnostic imaging is for women with abnormal screening mammograms. Women with a history of breast cancer or symptoms also need diagnostic imaging.
  • Time: Screening mammograms are generally very quick, taking about 10 minutes on average. Because they may need more images, diagnostic mammograms may take longer.
  • Preparation: Preparation for both types of mammograms is the same. Patients should not wear deodorant or wash it off before the exam.
  • Technology: The technology used for both types of mammograms is the same. At Premier, we use 3D Genius Mammography with SmartCurve for increased comfort. Additional tests, like sonograms, may go with the diagnostic mammogram.
  • Results: For both types of mammograms, a radiologist at Premier will read your images. They also send the results to your doctor. You can review the images and report in our Patient Portal within four business days of your exam.
  • Cost: Most insurances cover one screening mammogram per year. Diagnostic mammograms are subject to the terms of private insurance plans. (Please call our receptionists at 931-528-1800 to ask for details specific to your insurance plan).

Scheduling Your Mammograms

Understanding the differences between screening mammograms and diagnostic mammograms is important. If you’re unsure about what kind of digital mammography you need, ask your health care provider. 

Please see our mammogram page for more information about screening and diagnostic mammograms.


Getting Called Back After a Mammogram

Medically reviewed by Dr. Seth Means