Understand the Difference Between Diagnostic and Screening Mammograms

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, are used to diagnose and treat breast cancer. They can also be used to monitor follow-up after treatment or as part of a clinical trial.

The difference between screening and diagnostic mammograms may not seem like much at first glance. However, it’s helpful to understand the difference between the two before scheduling an appointment with your doctor.

What are Screening Mammograms?

Screening mammograms are a type of X-ray done to discover any unusual tissue in the breast. Commonly, these tests are performed routinely for people who have an average risk of disease and who have no symptoms.

Women should begin annual screening at age 40 and should continue throughout her life, for as long as she is healthy enough to undergo 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. Mammo images help detect cancers early when they’re much more treatable. These cancer screenings can spare many women from painful surgery, unpleasant chemotherapy treatment, or even death.

What are Diagnostic Mammograms?

A diagnostic mammogram is a type of imaging done to help radiologists make a specific diagnosis. They help determine if symptoms are indicative of the presence of cancer. As compared to screening mammograms, diagnostic mammograms provide a more detailed X-ray of the breast. 

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

Why would I need a diagnostic mammogram?

Your doctor may order a diagnostic mammogram if a screening has returned “abnormal” results or if you have symptoms or unusual breast changes. Symptoms that may need diagnostic imaging include things like lumps, pain, or nipple discharge. Changes in breast size, shape, or skin thickness are also symptoms that may cause your physician to order a diagnostic exam.

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

What is an “Abnormal” Mammogram?

While the word “abnormal” sounds like cause for concern, an abnormal mammogram just means that a woman’s breast imaging didn’t return the same results as other women her age.

An “abnormality” could be due to benign conditions, such as naturally occurring dense breast tissue, a cyst, or a non-cancerous tumor. Also, in some cases, images from the screening test could have distortions that result in inaccurate results. For this reason, we perform 3D mammograms at Premier Diagnostic Imaging. 3D mammograms are more accurate than the traditional 2D mammograms–reducing callbacks by 40% and detecting 20-65% more invasive breast cancer.

Does an Abnormal Mammogram Mean I have Cancer?

Many women who undergo a screening 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

As well as the difference outlined above, there are a few key differences between the two types of mammograms:

  • Purpose: Screening mammograms are preventative. Their purpose is to catch breast cancer in early, more treatable stages. Diagnostic mammograms further examine abnormal screening results or other breast issues. 
  • Who: Screening mammograms are generally performed on women over 40 who have no symptoms and who have average breast cancer risk factors. Diagnostic imaging is typically done for women with abnormal screening mammograms or who have a history of breast cancer or symptoms.
  • Time: Screening mammograms are generally very quick, taking about 10 minutes on average. Because they may require more images, diagnostic mammograms may take longer.
  • Preparation: Preparation for both types of mammograms is the same. Patients are asked to not wear deodorant or wash it off prior to 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 accompany the diagnostic mammogram.
  • Results: For both types of mammograms, a radiologist at Premier will read your images and forward the results to your healthcare provider. You will also be able to review the images and radiologist’s report in our Patient Portal within 4 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).

Though similar, it’s important to understand the differences between screening mammograms and diagnostic mammograms. If you’re unsure about what kind of mammogram you need, speak with your healthcare provider. 

Please see our mammogram service information for more information about screening and diagnostic mammograms and why you should choose Premier Diagnostic Imaging for your mammograms and other medical imaging needs.


Getting Called Back After a Mammogram

Medically reviewed by Dr. Seth Means

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