A diagnostic mammogram is a specialized imaging test providing detailed X-ray pictures of the breast. It investigates specific breast concerns or evaluates areas identified during routine screenings, helping healthcare providers examine tissue more closely.
Purpose of a Diagnostic Mammogram
A diagnostic mammogram is ordered when there is a specific reason to examine breast tissue in greater detail, setting it apart from a routine screening mammogram. While screening mammograms are performed to detect potential signs of breast cancer in individuals without symptoms, a diagnostic mammogram focuses on specific concerns. Common reasons for ordering this test include a suspicious finding on a previous screening mammogram, or the presence of new breast symptoms such as a lump, breast pain, nipple discharge, or changes in breast appearance like skin dimpling, puckering, or thickening. Although it investigates potential issues, it is an investigative tool to gather more information, and a concerning finding does not automatically indicate cancer.
Preparing for Your Appointment
It is advisable to wear a comfortable two-piece outfit, as you will need to remove clothing from the waist up and will be provided with a gown. Avoid applying deodorants, antiperspirants, lotions, creams, or perfumes to your underarms or breasts on the day of your appointment. These products can contain metallic particles that may appear as white spots on the mammogram images, potentially interfering with interpretation.
If you have had previous mammograms at a different facility, bring those images or reports, or ensure they are sent. This allows the radiologist to compare current images with past ones, which is crucial for identifying any changes over time. Inform the technologist about any breast concerns, recent changes, or implants, as this guides the imaging process and ensures appropriate views are taken.
The Diagnostic Mammogram Procedure
You will stand in front of a specialized X-ray machine in a dedicated imaging room. A technologist positions one breast at a time on a platform. A clear plastic compression paddle will gradually press against your breast, flattening the tissue for clear images. This compression, while brief, is necessary to spread out the breast tissue, reduce the amount of radiation needed, and minimize motion blur, which helps the radiologist see fine details.
Multiple views are taken, and for a diagnostic mammogram, the technologist may take additional spot compression or magnification views of a specific area of concern. The entire procedure usually lasts longer than a screening mammogram, often around 30 minutes, but can extend to 2 to 3 hours if additional images or an ultrasound are required. During the imaging, you may be asked to hold your breath for a few seconds. While breast compression can cause temporary discomfort or mild pain, it is generally brief and necessary for accurate imaging. In some cases, a radiologist may be present during the diagnostic mammogram to review images in real-time and request further views as needed.
Understanding Your Results and Next Steps
After the mammogram, a radiologist interprets the images. For diagnostic mammograms, results are often provided on the same day, sometimes before you leave the facility. This allows for immediate discussion of findings, options, and recommendations.
Possible outcomes can include normal findings, benign (non-cancerous) findings such as cysts or fibroadenomas, or findings that require further investigation. If additional information is needed, the radiologist may recommend next steps, which could include further imaging like a breast ultrasound or MRI, or a biopsy. A biopsy involves removing a small piece of tissue for microscopic examination to determine if it is cancerous. It is important to remember that callbacks for additional testing are common and do not automatically mean cancer is present; nearly 90% of diagnostic mammograms performed after a screening finding turn out to be benign. Follow-up is an important part of the process, and discussing any concerns with your healthcare provider ensures appropriate ongoing care.