A diagnostic mammography is a specialized breast imaging procedure. It investigates specific concerns about breast health, unlike routine screenings. It is performed when there is a particular symptom, an abnormal finding from a prior imaging test, or a need for closer examination of breast tissue. This imaging technique uses low-dose X-rays to create detailed images of the breast.
Diagnostic vs. Screening Mammography
Screening mammography and diagnostic mammography serve distinct purposes. Screening mammograms are routine examinations performed on asymptomatic women to detect potential breast changes. They usually involve a standard set of four images, two of each breast, taken from different angles. Their primary goal is to identify early signs of breast cancer.
A diagnostic mammogram is ordered when a specific issue needs further investigation. This could be due to a new breast symptom or an abnormal finding on a previous screening mammogram. During a diagnostic exam, more images are often taken, and specialized views like magnification or spot compression may be used to focus on a particular area. A radiologist is frequently present to review images in real-time, allowing for immediate guidance on additional imaging.
Reasons for a Diagnostic Mammogram
Several specific circumstances can lead a healthcare provider to recommend a diagnostic mammogram. One common reason is an abnormal result from a routine screening mammogram, where an area of concern requires closer examination. This finding warrants further investigation.
New breast symptoms are another frequent prompt. These can include a newly palpable lump, persistent breast pain, or unusual nipple discharge. Changes in breast skin, such as dimpling or redness, or nipple retraction also necessitate a diagnostic evaluation. A diagnostic mammogram may also follow up on known benign conditions or monitor areas of concern over time.
What Happens During the Procedure
Patients are advised to avoid wearing deodorant, antiperspirant, or lotions on the day of the exam, as these products can interfere with image quality. A technologist will explain the procedure and guide the patient to the mammography room. The breast is positioned on a plate and gently compressed, similar to a screening mammogram.
During the procedure, the technologist carefully positions each breast to obtain various views. Unlike screening mammograms, a diagnostic mammogram often involves additional, more targeted views such as spot compression or magnification. These specialized images help to closely examine a specific area of concern. A radiologist is often present to review images in real-time, allowing them to determine if additional images or an immediate ultrasound are needed. The entire procedure typically takes longer than a screening mammogram, often lasting between 30 minutes to an hour, depending on the complexity of the examination.
Interpreting Your Results and Next Steps
After a diagnostic mammogram, a radiologist typically provides preliminary findings immediately or soon after the examination. A formal, detailed report will be compiled and sent to the referring physician, usually within a few days. The findings are often categorized using the Breast Imaging Reporting and Data System (BI-RADS), a standardized scoring system ranging from 0 to 6. This system helps to communicate the level of suspicion and guides the next steps in patient care.
A BI-RADS 0 indicates an “incomplete” assessment, meaning that additional imaging, such as an ultrasound or MRI, is necessary to provide a complete evaluation. Other categories range from BI-RADS 1 (normal) to BI-RADS 6 (known biopsy-proven malignancy). The possible outcomes of a diagnostic mammogram can range from benign findings that require no further action to suspicious findings that necessitate further investigation. If the results are abnormal or inconclusive, the referring physician may recommend additional imaging tests, a breast biopsy to obtain tissue samples, or a follow-up diagnostic mammogram in a few months to monitor the area. Discussing these results thoroughly with the referring physician is important to understand the implications and determine the most appropriate course of action.