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A diagnostic mammogram is a detailed X-ray of the breast. Your doctor may order one after a breast cancer screening mammogram finds something unusual or if you have a symptom that needs a closer look.
It’s normal to be a little anxious if you’re called back for a diagnostic mammogram, but most of the time, the results of a diagnostic mammogram come back negative, showing no breast cancer.
In fact, fewer than 1 percent of people called back for additional testing turn out to have cancer. Even in the rare case that cancer is found, early detection of breast cancer greatly improves the chances of successful treatment and recovery.
Here’s what you should know before your appointment, including the difference between a diagnostic and a screening mammogram and the answer to questions like, “Why would a diagnostic mammogram be ordered?”
The terms “screening” and “diagnostic” seem similar. But here’s how these two types of breast cancer tests are different.
A screening mammogram is a routine screening for people with an average risk of breast cancer. The goal is to check for potential signs of breast cancer that don’t have noticeable symptoms.
Screening mammograms are usually done yearly after age 40. Some people may have them sooner, around 35, if they have a high risk of breast cancer.
A routine or screening mammogram usually includes four images. Each image is taken using a very small amount of radiation.
It’s important not to skip this quick 20-minute test. Advances in screening have helped lower breast cancer deaths by 43 percent.
A diagnostic mammogram isn’t a standard test that everyone has. It requires a doctor’s referral.
Diagnostic mammograms use the same technology as screening mammograms, but the radiologist takes more pictures for a closer look. Sometimes, this appointment also includes extra imaging tests, such as an ultrasound.
Diagnostic mammograms take longer than screening exams, but the results should come back sooner.
During a diagnostic mammogram, the technician takes several pictures at different angles. Then, the radiologist reviews the results and discusses them with you.
You may get your results before leaving the facility. Or, your doctor may call you to review them shortly after. You can ask about the process when you schedule your appointment.
A diagnostic mammogram is a more detailed test after a general screening. But neither type of mammogram can diagnose breast cancer.
Why Would a Diagnostic Mammogram Be Ordered? Diagnostic mammograms are ordered because of your other test results or symptoms you or your doctor notice. A diagnostic test takes a closer look at any areas of concern.
About 9 percent of women who have a screening mammogram get called back for a diagnostic mammogram. It helps explain anything unclear during your first visit.
A diagnostic mammogram may be ordered for symptoms, such as:
Although these symptoms don’t always mean breast cancer, they’re worth looking into.
It’s harder for radiologists to screen for breast cancer with implants. If a screening mammogram can’t fully capture your breast tissue, you may be referred for a diagnostic mammogram instead.
Diagnostic mammograms can be a proactive way to do closer screening if you have a high risk of breast cancer.
Your breast cancer risk may be higher depending on your genetics and family history. If you have a close relative with a history of breast cancer, ask your doctor about your risk factors.
What Do Diagnostic Mammogram Results Mean? Diagnostic mammograms are a useful tool for breast health. But it’s important to remember that they’re just one part of a bigger picture.
A diagnostic mammogram can’t diagnose breast cancer. Instead, it can rule out the need for more testing. Or, it can show signs of suspicious tissue. It’s also a good way to track changes over time.
Sometimes, diagnostic mammograms show a simple cyst. Cysts are fluid-filled sacs that usually aren’t cancer.
On a mammogram, cysts look round and smooth. They have distinct edges. On the other hand, a tumor is solid. It tends to be irregular and doesn’t have clear borders.
Diagnostic mammograms can also identify areas of dense breast tissue. Dense breasts increase the risk of breast cancer and make mammogram results harder to read. If you have dense tissue, you may need other forms of screening to accurately test for breast cancer.
What Happens Next?If your diagnostic mammogram doesn’t give a clear answer, your doctor will decide on the best way to follow up. Here’s what may happen next.
A breast ultrasound is often the next step. This breast imaging test uses sound waves to create pictures of the inside of the breast. It’s especially helpful for telling the difference between solid masses and fluid-filled cysts.
Ultrasound is painless and doesn’t involve radiation. Your radiologist can even have it done during your diagnostic mammogram.
If cancer is suspected, a biopsy can give a clear answer because it is the only test that diagnoses breast cancer. During a biopsy, a small sample of tissue is taken from the area and examined under a microscope.
There are different types of biopsies for breast cancer. Most are done with a needle and don’t require surgery.
Even if you’re told to have a breast biopsy, there’s still a high chance that you don’t have cancer. About 20 percent of breast biopsies reveal a breast cancer diagnosis.
Your first diagnostic mammogram may simply show that there’s something worth keeping an eye on. You may be asked to return in about six months for a repeat diagnostic mammogram.
You shouldn’t be worried if this happens to you. Studies show that just 2 percent of women who need a repeat test end up with a cancer diagnosis.
Sometimes, other imaging tests, such as a breast MRI, may be recommended. MRIs can be especially helpful for people at higher risk, including those with dense breast tissue.
Knowing what will happen during the test can help ease some anxiety. Here’s what you can expect on the day of your appointment.
Preparation for a diagnostic mammogram is the same as for a screening mammogram. This usually means keeping your skin clean and not wearing deodorant, lotion, body powder, or perfume.
Be sure to follow your doctor’s instructions before your appointment to avoid running into any issues at the imaging center.
Any type of mammogram can be uncomfortable. The test requires your breast to be squeezed with clear plastic paddles to get the images needed.
Since a diagnostic mammogram includes more images, it takes longer. If you have concerns about pain during your appointment, talk to your provider ahead of time. Ask what you can do to be more comfortable during your visit.
On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.
If you’ve had a diagnostic mammogram, do you have any advice for others facing the procedure? Let others know in the comments below.
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I was 80 yrs. old when I had my first radiation treatment. You can do this!!!! Hugs.
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