A mammogram may be done if you have breast problems such as a lump, pain, or nipple discharge. A mammogram is also done as a screening test if you don’t have breast problems. It can check for breast cancers, noncancerous or benign tumors, and cysts before they can be felt.
Chadwick M. Mills, MD, is an independent radiologist who chooses to practice at Franciscan Health hospitals in Crown Point and Michigan City. He answers your questions and shares expert insight on the differences between diagnostic and screening mammograms.
Q: What is the difference between a diagnostic mammogram and a screening mammogram?
A: This is a very common question that I get. The difference between the two has to do with the reason the mammogram has been ordered.
Screening mammograms are done starting at age 40 and annually thereafter. Screening mammograms are done routinely to find any breast changes in women without signs of breast cancer to find a tumor before it can be felt. The woman has had a physical exam by her clinician, there's been nothing found on the physical exam, and the woman has no complaints over any part of her breasts. This mammogram is just a routine screening. The woman comes to the hospital, gets a mammogram and then leaves relatively quickly.
A diagnostic mammogram is a little different. Most commonly there is something on the physical exam that the clinician has either felt, or it's an area of concern, or the woman has said that she has felt something in the breast that's a concern to her. These may include a lump, pain, nipple thickening or discharge, or a change in breast size or shape. In some cases, both the clinician and the patient have felt an abnormality in the breast. A diagnostic mammogram will be ordered, and a breast imager on site will actually look at the study. They will orchestrate it and then they will answer a question before the woman leaves.
It is a myth that the diagnostic mammograms are better than the screening mammograms. It's just a difference in how the mammogram was ordered and why it's been ordered.
One very important thing to note if you're having your annual mammograms - and you should starting at age 40 - you should always make sure that if you didn’t have prior studies at that facility to get those images sent to that location where you're going to have your mammograms. You can do this in one of two ways. One is you can actually go to that center, and they will give you a disc with your studies on it. If you had your previous mammograms done out-of-state or it’s too far or less of a convenience, you can sign a medical release form. The imaging center can have the films brought over to the location where you're going to have the mammogram. They will be ready at the time that you have your mammogram.