A diagnostic imaging appointment is scheduled when a specific breast concern needs investigation, such as a lump, pain, or nipple discharge, or to further evaluate an abnormal finding from a prior screening mammogram. The purpose of this visit is to gather detailed images and information to determine the cause of the concern.
Diagnostic Imaging: Why It Differs From Screening
Diagnostic imaging differs from screening imaging in its purpose. Screening mammograms are routine, preventative measures for people with no symptoms. Diagnostic imaging is an investigative tool used to scrutinize a known or suspected issue.
This appointment is more comprehensive and takes longer than a screening, often lasting 30 minutes to an hour and a half. A radiologist specializing in breast imaging is often present to review the initial images immediately, determining if additional specialized views or an ultrasound are necessary.
The Diagnostic Mammogram Procedure
The diagnostic work-up usually begins with a mammogram using the same equipment as a screening exam. The technologist captures specialized views of the specific area needing further evaluation. These additional images often involve techniques like spot compression and magnification views. The images are reviewed by the radiologist while you wait, which is why the appointment can feel segmented as the next step is determined.
Spot compression uses a smaller paddle to apply more pressure to a localized area, helping to define a mass or distortion. Magnification views provide a closer look at small details, such as microcalcifications, to assess their shape and pattern. Positioning the breast to capture the best image of the area of interest may cause brief, localized discomfort.
The Targeted Breast Ultrasound
A targeted breast ultrasound provides additional information about the area of concern. This procedure uses high-frequency sound waves to create real-time pictures of the tissue without using ionizing radiation. A technologist or radiologist performs the ultrasound by applying warm gel and moving a handheld device called a transducer over the skin. The term “targeted” means the clinician focuses exclusively on the specific spot identified on the mammogram or felt during an exam.
Ultrasound is crucial because it determines whether a finding is solid or fluid-filled. A fluid-filled sac is usually a simple cyst, which is considered benign and requires no further action. If the finding is a solid mass, the ultrasound provides detailed information about its shape, borders, and internal structure to assess the likelihood of it being cancerous.
Receiving Results and Follow-Up Care
At the diagnostic appointment, you receive preliminary results and a plan of action before leaving the facility. The radiologist summarizes the findings using a standardized reporting system to communicate the level of suspicion associated with the results. This system classifies the findings into categories, each with a specific recommendation for follow-up care.
The outcome generally falls into three areas. If the finding is clearly benign, you return to your routine annual screening schedule. If the finding is likely benign but requires short-term monitoring, a follow-up exam, often a repeat ultrasound, is recommended in about six months. If the imaging reveals suspicious features, the radiologist will recommend a biopsy to obtain a tissue sample for definitive diagnosis.