UCHealth: Screening versus diagnostic breast imaging
For Craig Press
For many women, when the calendar turns to October, it serves as a reminder to schedule a mammogram.
But do you schedule a screening mammogram or a diagnostic mammogram?
“Screening mammography is for patients who have no symptoms related to their breasts, but want to get evaluated for signs of breast cancer because it is such a common illness,” said Dr. Malaika Thompson, a breast radiologist at UCHealth Gloria Gossard Breast Care Center in Steamboat Springs. “Conversely, diagnostic mammography is for patients who have symptoms, such as a lump, change in the appearance of the breast, skin variations like dimpling or thickening, spontaneous discharge or pain in one spot in a breast that is not related to menstrual cycles.”
Who needs a mammogram?
Screening mammograms are recommended annually for women age 40 and older. There is no upper age limit; however, other illnesses and life expectancy are factors to consider.
Diagnostic mammography is for women and men, age 30 and older, who are experiencing symptoms related to the breast, chest and/or armpit, and to evaluate changes or new abnormalities found on screening mammography. It is also used to follow-up on areas previously evaluated that have a strong likelihood of being benign to look for change or to confirm long-term stability. For women less than 30 years of age, ultrasound is used first to determine if there is a need for mammography.
Do both types of mammograms feel the same to the patient?
Yes. Both feel very similar as far as how much compression is needed.
During screening mammograms, the breasts are positioned in very standard ways to allow comparison from year to year.
“With diagnostic exams, we start with the same, standard images as in screening studies,” said Thompson, “then take more specialized pictures that target areas needing specific attention — either because there are associated symptoms or because the pictures show something that needs to be further evaluated.”
Are 3D images an option with both?
Yes. All mammograms done at UCHealth Gloria Gossard Breast Care Center are done with tomosynthesis, or 3D, imaging.
Does one type expose the patient to more radiation than the other?
According to Thompson, diagnostic mammography can have a minimally higher radiation dose if more pictures are needed to solve the problem. But overall, both have a significantly lower dose than most x-rays, CTs, and nuclear medicine studies.
Are there other procedures that have both a screening and diagnostic version?
Yes. All breast imaging studies at UCHealth Gloria Gossard Breast Care Center have both a screening and diagnostic version — mammograms, ultrasound and MRI.
Why is screening important?
Screening mammography helps find breast cancer early, when the treatment is easier with less impact to the patient.
“With one in eight women developing breast cancer sometime in their life, screening is needed in every woman,” said Thompson. “It has been shown to reduce the risk of women in the United States dying from breast cancer by 40% since 1990. Because 75% of breast cancer diagnoses occur in women with no family history, it’s important for every woman to receive regular screening mammograms.”
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