Breast Care

Screening vs. Diagnostic Mammograms

Learning which breast cancer screening options are right for you

Regardless of one's stage in life—be it a young child getting a vaccination or a grown woman going in for a routine mammogram—it's very important to get annual screenings and exams as part of a preventative healthcare plan.

For some women, however, the thought of an annual mammogram can evoke fear and stress.

"The truth is a 10- to 15-minute screening mammogram can help save your life," said Eileen Kenny, M.D., breast imager and medical director of Carilion Clinic's Breast Care Center.

Carilion's Breast Care Center recommends women age 40 and older get a mammogram every year. For women with higher risk factors, such as a family history of breast cancer, screenings may be recommended at an earlier age.

While no woman wants to hear that there may be something suspicious on a mammogram, it's important to know most abnormalities found on mammograms are not breast cancer.

"A screening mammogram takes images two ways: from top to bottom and from side to side," Dr. Kenny said. "So if we see something that looks suspicious or different than on a previous mammogram, it could be something as simple as tissue overlapping or a cyst, and we'll need to do more testing to rule out the possibility of cancer."

Patients don't need a referral from a doctor to receive a screening mammogram, but they will need to give the name of their physician so that a report can be sent for follow-up care. Research shows potential abnormalities are found in up to 11 percent of women who have screening mammograms. These women are usually called back for further testing, which can include a diagnostic mammogram or breast ultrasound.

There are two types of mammograms: screening and diagnostic. By definition, a screening test is done to screen people who are at risk of developing a disease but do not have any symptoms.

A diagnostic mammogram is done to clarify suspected abnormalities on a screening mammogram or to evaluate a women with signs and symptoms of breast cancer or other breast problems.

After a mammogram and a breast ultrasound, a biopsy is sometimes needed to determine whether there is actually cancer in the breast.

"We make it very convenient for our patients," Dr. Kenny said. "We can do biopsies in our facility in a timely manner, so a patient can return to work on the same day, if needed."

Results of a screening mammogram or a breast ultrasound are given to patients by the breast imager the same day as their testing. Biopsy results are usually given by the next day.

"It's important to us to let our patients know their results as soon as possible," Dr. Kenny said.

If you have an appointment scheduled for a routine screening mammogram, but feel something abnormal in your breasts, don't wait for that appointment. Call your doctor as soon as possible. You will need an order for a diagnostic mammogram instead.

"Most lumps turn out to be a cyst or noncancerous growths, such as fibroadenomas, but its best not to assume this," Dr. Kenny said. "By being tested early you can alleviate a lot of unnecessary worry. If it is cancer, the earlier you find it the better your chances of survival."

If you are 20 years or older you should do breast self exams every month. The best time to do this is within a few days after your menstrual cycle is over. Lying down may help more to find deeper masses than can be found while examining your breast in the shower. A lot depends on your breast size. Both ways are helpful. Also make sure to check under the arms for enlarged lymph nodes.

"The goal of screening is to save lives," Dr. Kenny said. "The earlier cancer is found, the more treatable it is, and the greater chance a person has of surviving. Make screening part of your yearly health routine."

Laura Markowski is a writer for Carilion Clinic's marketing communications department.