Diagnostic Mammogram

What is Diagnostic Mammogram?

A diagnostic mammogram uses low dose x-ray to evaluate a breast concern or to "get a closer look" at a finding on a recent screening mammogram. The special views may use 3D mammography, magnification, or spot compression views to further characterize an area of interest. A breast complaint such as a lump, nipple discharge, or focal pain may require special diagnostic images to be interpreted by radiologists specialized in this field.

The purpose of the diagnostic mammogram is to distinguish normal structures that are components of the breast from abnormal lesions. A diagnostic mammogram can detect subtle differences in the cellular structure or patterns of the tissues. Mammogram abnormalities may present as distortion, masses, or small white spots called cluster microcalcifications. Obtaining a diagnostic mammogram provides the clearest images to characterize an abnormal finding.

On additional imaging evaluation, most abnormal mammogram findings will prove to be benign (noncancerous). However, diagnostic mammography imaging is necessary to distinguish these findings from malignancy (cancer). The radiologist can only render an opinion after obtaining the specialized imaging. For example, calcifications seen on a mammogram may be characterized as fibrocystic after additional imaging or may be characterized as cluster calcifications that require further workup. Most cluster calcifications are benign (noncancerous), but the closer look can help to distinguish these.

Screening mammography looks at "the big picture," while diagnostic mammography provides "the detail."

What Details Should I Tell the Scheduler and Mammography Technologist?

Please tell the scheduler and technologist if you have any particular breast concerns. These concerns may include:

• New lumps
• Asymmetric thickening
• Focal pain
• New nipple inversion or discharge
• Skin redness or warmth
• Swelling or change in size
• Lymph node enlargement or pain

Please tell the scheduler and technologist if you have had a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation. Supplemental imaging such as breast MRI may be indicated at a later date.

If you have breast implants or breast complaints, we will need extra time to perform and interpret the imaging examination. 

What to Expect With a Diagnostic Mammogram

We want to make you as comfortable as possible during your diagnostic mammogram. Here’s what you can expect for your procedure.

Before the Mammogram

Please do not apply deodorant on the day of your mammogram. Applying deodorant can interfere with the ability of the mammogram to distinguish aluminum artifacts (found in most deodorants) from microcalcifications, which may be the earliest sign of breast cancer.

Wear a two-piece outfit if possible, as you will be changing into a waffle robe so the mammography technologist has the best access to perform the imaging exam.

During the Mammogram

The technologist will walk you through the positions needed to obtain the best radiology images. They will ensure you are comfortable during the imaging exam at every step. Unlike a regular Mammogram where there is just one type of paddle, with a 3D Diagnostic Mammogram, there are multiple paddles. The same mammogram machine is used for performing screening and diagnostic exams. The difference is the use of specialized compression paddles, magnification or different angles used for “diagnostic mammogram imaging” exams to bring out characteristics of benign versus malignant tumors.

To obtain magnification views of calcifications, we gently place the breast onto a large stand on the mammogram machine while using a smaller spot compression paddle to press through the tissue. This process helps us better determine if a breast mass or architectural distortion is present. The amount of pressure needed for the correct exposure is based on the thickness and density of the breast. We want to keep the breast in the same position to avoid motion that may cause blurriness of the image. The mammography technologist will ask you to hold your breath for a few seconds while she obtains the exposure. Diagnostic mammography uses high-resolution, low-dose x-rays of the breast, and we may obtain one or more imaging views of a particular finding. Breast implants do not typically pose a problem. Our technologists are highly experienced in performing diagnostic mammograms, including with implants.

After the Mammogram

If we notice an area that persistently appears abnormal after diagnostic breast imaging, the radiologist may recommend a minimally invasive breast biopsy.

Frequently Asked Questions About Diagnostic Mammograms

Why would a Diagnostic Mammogram be ordered?

To evaluate a breast concern such as breast lump, discharge, pain, or to further characterize an abnormal area seen on a screening mammogram. 

How is a Diagnostic Mammogram performed?

A diagnostic mammogram is performed using low dose x-ray to evaluate a breast concern such as breast lump, discharge, pain, or to further characterize an abnormal area seen on a screening mammogram. The same mammogram machine is used for performing screening and diagnostic exams. The difference is the use of specialized compression paddles, magnification or different angles used for diagnostic exams to bring out characteristics of benign versus malignant tumors.