On This Page

Diagnostic Mammograms

Your breast health is a critical part of your overall well-being, and diagnostic mammograms are an important way to understand and monitor changes in the breast and spot signs of breast cancer. Diagnostic mammograms are very detailed X-rays of the breast tissue that are performed in patients with significant risk factors for breast cancer, or those who have been referred after a lump or other breast abnormality has been detected.

 

If you are a woman over the age of 40, you are likely already familiar with screening mammograms, which are performed annually to proactively find and respond to possible issues in the breast (related: Screening Versus Diagnostic Mammograms: What You Can Expect). Screening mammography is one of the most effective ways to detect breast cancer in its earliest stages, in which treatment and recovery outcomes are best.  
 
If your screening mammogram detects abnormalities, or if you have breast pain, a palpable lump or an elevated risk for breast cancer, you will then be referred by your physician or radiologist for a diagnostic mammogram. 

 

Both types of mammograms, screening and diagnostic, help your breast radiologist rule out or help diagnose breast cancer. Breast ultrasound is ordered alongside a screening or a diagnostic mammogram to help radiologists get additional information about the areas of concern and to evaluate dense breast tissue. 

 

At Houston Methodist, our board-certified radiologists use advanced 3D technology to detect the smallest lumps and abnormalities with accuracy. Our radiologists will review your diagnostic mammogram and provide same-day results, often while you are still in our Breast Care Center. 

When to Get a Diagnostic Mammogram

Diagnostic mammograms are used to both find and rule out breast cancer. Being referred for a diagnostic mammogram may be frightening, but it doesn't mean that you have breast cancer. A diagnostic mammogram may be recommended for two reasons: when a routine screening mammogram shows an abnormal result, or you if you experience symptoms that may indicate breast cancer.
 
To know when you should get a diagnostic mammogram, first be sure to prioritize your annual screening mammogram, as many abnormalities can be caught at this stage. If you aren’t due for a screening but you notice one of these symptoms below, reach out to your primary care doctor or gynecologist right away — he or she can provide insight on whether you need a diagnostic mammogram, and, if you do, will provide a referral.

If you experience any of the symptoms listed below, you should see your primary care doctor or gynecologist right away — he or she will provide you with the necessary doctor's order for a diagnostic mammogram.

Suspicious Mammogram Findings

Some suspicious mammogram findings that can prompt your doctor to order a diagnostic mammogram can include:

 

  • Architectural distortion: This is when no lump or mass is seen, but there is an oval or round pattern of breast tissue on a mammogram. 
  • Calcifications and microcalcifications: These are bright white spots on mammograms that can range in size. Calcifications are often benign, but tight, clustering microcalcifications can indicate breast cancer.
  • Ductal carcinoma in situ (DCIS): This is when abnormal cells are located in the milk ducts but have not spread to other parts of the breast.
  • Masses: A white patch or mass, that can have spiky or fuzzy edges, may indicate breast cancer. 

Breast Cancer Symptoms

Additionally, your doctor may order a diagnostic mammogram if you experience symptoms such as:

 

  • Lumps, hard knots or thickening inside the breast or underarm
  • Breast swelling, warmth, redness or darkening
  • Changes in breast size or shape
  • Skin dimpling or puckering
  • An itchy, scaly nipple sore or rash
  • Nipple or breast inversion or retraction
  • Sudden nipple discharge
  • New pain in one spot that does not go away

Call Us to Schedule With a Provider Today

What You Need to Know About Your Diagnostic Mammogram

  • How to Prepare
  • What to Expect
  • Understanding Your Results
  • Insurance and Cost
  • How to Prepare

    Preparing for your diagnostic mammogram is simple:

    There are no special instructions you must follow before a diagnostic mammogram. You may want to wear comfortable clothes, including a top with pants, shorts or a skirt. That way, you will only have to remove your top and bra during the appointment. You will want to skip applying deodorant, lotions, powders or creams before your appointment. If you forget, our Breast Care Center care team will provide you with wipes to remove any of these products — they can appear as white spots on the images, which can affect the reading of your mammogram. 

     

    If there is a risk you may be pregnant, please contact your doctor who will likely reschedule your appointment.

  • What to Expect

    What to expect during your diagnostic mammogram:

    A diagnostic mammogram is similar to a screening mammogram, though they usually last a little longer. Your breast technologist will walk you through each of these steps:

     

    • Check in and fill out any necessary forms.
    • In the changing room, you will remove your top and bra, wipe off any deodorant or lotions, and put on a robe.
    • You will be taken to the exam room, where a mammogram technologist will ask about your breasts and any concerns you may have.
    • The technologist will position one of your breasts on the machine, which will briefly compress your breast while the technologist takes X-ray images of the breast. 
    • This process is then repeated to get the four standard images for each breast.
    • Your technologist will then do spot compression or magnification to get additional images of any areas of concern.
    • Next you will have your ultrasound (if that was scheduled as part of your appointment).
    • Your breast radiologist or technician in most cases will talk with you immediately about your results and any next steps.
    • Finally, you will go back to the changing room to get dressed. You may be asked to follow up with your health care provider or with your breast care team.
  • Understanding Your Results

    What your diagnostic mammogram results mean:

    A diagnostic mammogram report will include details about breast tissue, including the density of breast tissue, as well as any areas of concern, such as lumps or calcifications (tiny mineral deposits). 

    The results of both diagnostic and screening mammograms are coded by a standard coding system, the Breast Imaging Reporting and Data System (BI-RADS) system. The results use a BI-RADS numbers 0 through 6: 

    • BI-RADS 0: Your study is not yet complete and more information is needed. If this is included in the report, additional testing may be needed, such as magnetic resource imaging (breast MRI), ultrasound, 3D mammography, molecular breast imaging (MBI) or contrast enhanced mammography (CEM). 
    • BI-RADS 1 or 2: Your study may be normal, but this category also includes other benign findings, such as cysts. 
    • BI-RADS 3: This means your study is probably benign (not cancer) but there is a finding that needs follow-up, usually done with a short-term interval mammogram and ultrasound in six months. The chance of cancer in this category is low but not zero.
    • BI-RADS 4: This means the findings in your study are suspicious for cancer and a breast biopsy is indicated. You should talk to your doctor who will likely order the biopsy.
    • BI-RADS 5: This means the findings are highly suspicious for cancer. You should talk to your doctor who will order the biopsy. 
    • BI-RADS 6: This means you have been diagnosed with cancer and you should discuss your treatment and imaging plan with your physician. 
  • Insurance and Cost

    Understanding insurance and the cost of a diagnostic mammogram:

    Insurance may cover the cost of a diagnostic mammogram at Houston Methodist. Most of the time, annual screening mammograms are considered preventative care and are totally covered, but diagnostic mammography can vary based on the type of insurance you carry and what is outlined in your plan. It is possible you will be required to provide a co-pay or coinsurance. It is always best to check with your health insurance provider to understand what your plan will cover.
Benefits of Diagnostic Mammograms

Benefits of Diagnostic Mammograms

 

Diagnostic mammograms offer many of the same benefits as screening mammograms, including:

 

  • Early detection: Catching breast cancer at an early stage, potentially before symptoms appear, can increase the likelihood of successful treatment and better outcomes.
  • Monitoring changes: Regular mammograms allow doctors to monitor changes in breast tissue over time, which helps in identifying any new or suspicious developments early.
  • Guiding treatment: If cancer is diagnosed, a diagnostic mammogram will be an important step in building a breast cancer treatment plan that is unique to you and your situation.

Convenient Locations Across the Greater Houston Area

Whether you’re high risk or average risk, or aren’t sure about your family history, a breast cancer screening is the very best way to spot early warning signs of breast cancer. If your screening mammogram shows an abnormality, or you have other unusual breast symptoms, a diagnostic mammogram is your best next step.

We understand that this can be a scary prospect, and that is why we have a radiology and breast technician team who understand your concerns and treat you with compassion and empathy. When you choose Houston Methodist, you’re choosing the highest level of leading-edge treatment, and the highest level of personal care. 

Schedule your appointment or call to learn more about diagnostic mammogram today.

Load More Locations

FAQs About Diagnostic Mammograms

TOP