What is a 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, discharge, or focal pain may require special mammographic radiology images by a mammogram technologist and always requires the attention of the radiologist.
- 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 the clearest images of the breast with special digital mammograms allows the best opportunity to characterize an abnormal finding.
Note that most mammographic findings will prove to be benign (noncancerous) on additional imaging evaluation. However, diagnostic mammography imaging is necessary to distinguish these findings from malignancy (cancer). The Women’s Imaging radiologist cannot render an opinion without obtaining the imaging needed. For example, calcifications seen on a mammogram may be characterized as fibrocystic after added imaging or may be characterized as cluster calcifications that require further workup. Even most cluster calcifications are benign (non cancerous), but we need to be sure.
- Screening Mammography is “the big picture” while Diagnostic Mammography is “the detail”.
What Details Should I Tell the Scheduler and Mammography Technologist?
Tell the scheduler if you have any particular breast concerns. For example, do you feel any new breast lumps? Is the nipple inverting? Other common complaints include focal pain or achiness, unusual nipple discharge, skin redness or warmth, swelling, a new change in the size of the breast, swelling under the arm, lymph node enlargement.
- If you have breast implants or have complaints within both breasts, please tell the scheduler to allow adequate time.
- If you have had a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation, please tell the scheduler and technologist. Supplemental imaging such as breast MRI may be indicated at a later date. It cannot be added on the same day as the diagnostic workup for insurance authorization reasons.
How to Prepare for Your 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 because you will be changing into a cotton robe so that the mammography technologist has the best access to perform the imaging exam.
- Please tell us the location of your prior examinations so that we may request these ahead of your visit. Many radiology departments use PowerShare as we do to quickly electronically send your images to us. Note that some facilities will not release the outside images to us ahead of time until you have signed a release form when you first establish care at any of our Women’s Imaging Center locations. Our digital film librarian will gladly facilitate this process for you 303-321-2273 x 237
How Is the Diagnostic Mammogram Performed?
The technologist will walk you through the process of what positions are needed to obtain the best radiology images. She will ensure you are comfortable during the imaging exam at every step. Different kinds of special paddles are added to the regular 3D mammogram machine for “diagnostic mammogram imaging”.
- To obtain “magnification” views of calcifications, the breast is gently placed onto a large stand on the mammogram machine. While a smaller “spot compression” paddle is used to “press’ through the tissue better to 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.
Who Is Reading Your Mammogram? Experience Matters
The specialized Breast Radiologists at The Women’s Imaging Center interpret the images. Our radiologists are all fellowship-trained specialists in breast and women’s imaging far exceeding the national standards. They have trained at the most rigorous institutions in the county and have received the highest awards for excellence. You will receive your results at the time of your study and will have the opportunity to talk with the radiologist.
What if a Persistent Abnormality Is Found?
If there is a persistent abnormal appearing area after the diagnostic breast imaging, the radiologist may recommend a minimally invasive breast biopsy. All of our minimally-invasive breast biopsies are performed within our Centers for your comfort, convenience, and continuity of care. If a biopsy is indicated, then the results will be available within two working days.
- At The Women’s Imaging Center, you will have a whole Care Team involved with your care. Your team will consist of a mammography technologist, a specialized radiologist, a medical assistant, and a patient navigator.
Your Care Team ensures the continuity of care and treatment (if indicated) from start to finish. If treatment for an atypical, precancerous, or cancer result is needed, we can perform any additional pretreatment imaging such as breast MRI or needle localization at The Women’s Imaging Center. The Care Team and navigator coordinate your care among other specialists including the radiologist, surgeon, or other specialists based on the recommendation of your referring clinician or within the continuity of care following the National Comprehensive Cancer Network (NCCN) guidelines or the American Cancer Society (ACS) recommendations.