A diagnostic mammogram is a specialized breast imaging procedure that uses low-dose X-rays to obtain detailed images of breast tissue. Healthcare providers order this type of mammogram to investigate specific concerns or to further evaluate an area of interest within the breast. The primary goal is to gather more information to help determine the cause of a breast symptom or an abnormal finding.
Understanding the Difference
A key distinction exists between a screening mammogram and a diagnostic mammogram, primarily in their purpose. A screening mammogram serves as a routine preventive check, typically performed annually for individuals without breast symptoms, aiming to detect potential changes before they can be felt.
In contrast, a diagnostic mammogram is ordered when there is a specific breast symptom, a palpable concern, or an abnormality identified during a screening mammogram. While both use similar technology, their intent and approach differ significantly.
Key Reasons for Ordering
Several medical indications prompt a healthcare provider to order a diagnostic mammogram.
One common reason is an abnormal finding on a routine screening mammogram, such as a suspicious mass, calcifications, or an area of asymmetry. These initial findings necessitate further evaluation.
The discovery of a new breast lump or mass, whether by the patient or during a clinical breast examination, also leads to a diagnostic mammogram. This imaging helps characterize the lump, assessing its characteristics to differentiate between benign and potentially concerning findings.
Persistent or localized breast pain can also warrant this type of mammogram. While breast pain is frequently benign, a diagnostic mammogram helps rule out underlying issues.
Certain types of nipple discharge, such as spontaneous, bloody, or clear discharge, are another reason for a diagnostic mammogram. The imaging can help identify any associated masses or ductal abnormalities. Skin changes on the breast, including dimpling, redness, thickening, or a newly inverted nipple, also necessitate a diagnostic evaluation. These visual changes can indicate underlying breast conditions.
Additionally, individuals with a history of breast cancer often undergo diagnostic mammograms for follow-up and monitoring. This helps detect new changes, potential recurrence, or assess treatment effectiveness.
What Happens During the Procedure
Undergoing a diagnostic mammogram typically involves a more detailed process than a screening mammogram. While the basic machine is the same, the technologist often takes more images and specialized views of the area of concern. These additional views can include spot compression, which applies more pressure to a small area, or magnification views, which enlarge a suspicious area.
A radiologist, a physician specializing in interpreting medical images, may be present during the diagnostic mammogram to review the images in real-time. This allows them to guide the technologist in obtaining additional views as needed. Often, a breast ultrasound may follow the mammogram to further evaluate the area, providing complementary information about the tissue’s composition.
Next Steps After Your Mammogram
After a diagnostic mammogram, results are often communicated directly to the patient before leaving the imaging center, which differs from screening mammograms where results may take longer. Radiologists use a standardized system called BI-RADS (Breast Imaging Reporting and Data System) to categorize findings, with scores ranging from 0 to 6. A score of 0 indicates that more imaging is needed, while a score of 1 or 2 means no suspicious findings were identified.
Different outcomes may lead to various next steps. If the findings are benign, you may return to your routine screening schedule. Sometimes, a short-term follow-up mammogram in six months is recommended for findings warranting monitoring. In other cases, further imaging like an MRI may be suggested, especially for high-risk individuals or complex findings. If a finding remains suspicious, a biopsy, which involves removing a small tissue sample for laboratory analysis, may be recommended to determine if cancer cells are present. It is important to discuss all results and recommended next steps thoroughly with your healthcare provider.