Do I need a screening mammogram or a diagnostic mammogram? Your questions answered

A mammogram is a great tool to check on your breast health. By providing detailed images of your breast tissue, this X-ray imaging test allows your care team to look for signs of breast cancer. And the earlier you detect breast cancer, the more treatment options you have.

While many women have heard about the importance of mammograms, it’s common for them to ask, “Do I need a screening mammogram or a diagnostic mammogram?” These two types of mammograms have some similarities, but there are also some key differences.

Get to know the difference between a screening mammogram and a diagnostic mammogram so you can be proactive in caring for your breast health.

What is a screening mammogram?

Like other cancer screenings, a screening mammogram is used to look for signs of cancer before you have symptoms. With a screening mammogram, you may be able to detect breast cancer before you feel a lump or see visible changes in your breast.

Often, breast cancer doesn’t cause symptoms until it’s started to grow or spread. A screening mammogram lets you catch breast cancer earlier. When breast cancer is detected while it’s still localized to one place in the breast, the five-year survival rate can be 99%.

“If you have an average risk of breast cancer, you should talk to your doctor about getting a screening mammogram every year starting at age 40,” said Amy Balis, MD, the medical director of the Women’s Imaging Center at Baylor Scott & White Medical Center – Irving. “If you have a family history or other risk factors for breast cancer, ask your doctor if you should start screenings sooner.”

What is a diagnostic mammogram?

The goal of a diagnostic mammogram is to help diagnose the source of symptoms or provide more information about an abnormal finding, such as a lump, breast pain or changes in your breast. This type of mammogram gives your care team more detailed images of the breast tissue compared to a screening mammogram.

“A diagnostic mammogram allows us to carefully look at any suspicious areas and get more information,” Dr. Balis said. “Your doctor might order a diagnostic mammogram if you notice changes in your breasts or as a follow-up to an abnormal screening mammogram.”

Screening vs. diagnostic mammogram: What’s the difference?

One of the major differences between a screening mammogram vs. a diagnostic mammogram is the purpose. The first type is used as a screening when you don’t have symptoms, while the other is used to get more details when you do have symptoms or following an abnormal screening exam.

With both screening and diagnostic mammograms, you’ll have images taken by the same type of imaging machine. The prep is also similar, for example, avoiding wearing deodorant, lotion or jewelry and changing into a gown at the imaging center.

But with a diagnostic mammogram, you can also expect the following:

• Diagnostic mammograms sometimes take more images than a screening mammogram. Your technologist may use additional imaging techniques to get the images you need.
• Expect your diagnostic mammogram to take longer than a screening mammogram due to the additional images.
• You’ll get the results faster with a diagnostic mammogram—often on the same day as your test.
• While most screening mammograms are covered by insurance as preventive care, you may have out-of-pocket charges for a diagnostic mammogram.

When should you consider a diagnostic mammogram?

Some women have a diagnostic mammogram after abnormal findings on their screening mammogram. But by being aware of the typical look and feel of your breasts, you may catch symptoms that need to be checked, too.

“If you notice changes in your breasts, you should let your doctor know right away,” Dr. Balis said. “Your symptoms may not be caused by breast cancer. But the sooner you get checked out, the sooner you can get to the information you need to plan your next steps.”

Let your doctor know if you have breast changes such as:

• A lump or thick area you can feel in your breast or armpit area
• Changes in the nipple, including color changes, discharge or an inverted nipple
• Redness, dimpling, scaling, flaking or an orange-peel texture on the skin of your breast
• Swelling or changes in the size of your breast

Even if you recently had a clear screening mammogram, speak up about your symptoms. If you have a high risk of breast cancer and notice symptoms, it’s especially important to get checked. Your doctor may also order other tests along with a diagnostic mammogram.

Mammogram results: What to expect

For screening mammograms, you can expect to get your results in a few days. If nothing is found, you can continue your normal annual screenings. If your results show an area that needs another look, your doctor will have you come back for additional images.

If you have a diagnostic mammogram, you will get your results back faster, usually on the same day. If the radiologist finds something, common follow-up tests include a breast ultrasound, breast MRI or a biopsy.

“It’s normal to feel anxious when you need additional testing, but know that you are doing what’s best to stay on top of your health,” Dr. Balis said. “With the information provided through these tests, you can make informed choices—no matter the results.”

Common myths about mammograms

Some women aren’t aware that they can get a screening mammogram without a referral. While a diagnostic mammogram typically requires an order from your doctor, a screening mammogram does not. You can schedule it directly with your imaging center.

Another common misconception is that if you don’t have any risk factors for breast cancer, you don’t need a mammogram. While routine screening is important if you have a high risk of breast cancer, it’s just as important for women with an average risk, too.

“Most people who are diagnosed with breast cancer don’t have any family history of the condition,” Dr. Balis said. “Only about 5-10% of cases of breast cancer are linked to a hereditary cause, so mammogram screenings are a valuable tool for women at all risk levels.”

Time for your yearly screening mammogram? We’re here to make it easier. Schedule your mammogram online now.