Screening Mammogram vs. Diagnostic Mammogram

According to the National Cancer Institute, “Early detection of breast cancer with screening mammography means that treatment can be started earlier in the course of the disease, possibly before it has spread. Randomized clinical trials and other studies show that screening mammography can help reduce deaths from breast cancer among women ages 40 to 74 years at average risk of breast cancer, with the evidence of benefit being strongest for women ages 50 to 69 years.”

Knowing the need for regular mammograms, many women will then begin to research and learn more about the test. However, this research will yield results not only on screening mammograms, but also on diagnostic mammograms. And while these two types of tests are different, it is important to understand the differences and use cases of both screening and diagnostic mammograms.

What is a screening mammogram?

The easiest ways to differentiate between a screening mammogram and a diagnostic mammogram are when and why you need the tests.

Screening mammograms are typically the “first” mammogram a woman will get if they are not presenting any visible symptoms. These are the mammograms that women aged 40 and over are recommended to get at least annually as a preventative measure and are often discussed at a well woman exam. They are very quick, typically only taking 10 to 15 minutes, and will help determine if you need further testing.

As the National Cancer Institute explains, “Screening mammograms usually involve two or more x-ray pictures, or images, of each breast. The x-ray images often make it possible to detect tumors that cannot be felt. Screening mammograms can also find microcalcifications (tiny deposits of calcium) that sometimes indicate the presence of breast cancer.”

If the screening mammogram does have abnormal results, that’s when a diagnostic mammogram will come into play and possibly ordered by a physician.

Remember, abnormal results aren’t just because of cancer. Everything from dense breast tissue to cysts to benign tumors could all cause these results, and further testing is necessary for pinpointing the cause.

What is a diagnostic mammogram?

A diagnostic mammogram is typically the “second” test a woman will receive if they go in with no visible signs of cancer and aren’t considered “at risk”. It is most commonly recommended if the screening mammogram identifies something the doctor wants to investigate further. However, women who are already presenting with potential signs of cancer such as lumps, or women who have breast implants, will often not undergo a screening mammogram and will likely go straight to a diagnostic mammogram.

“While screening mammograms are routinely administered to detect breast cancer in women who have no apparent symptoms, diagnostic mammograms are used after suspicious results on a screening mammogram or after some signs of breast cancer alert the physician to check the tissue,” National Breast Cancer Foundation, Inc., explains.

A diagnostic mammogram, however, isn’t indicative of a definitive cancer diagnosis. In fact, these tests are often used to rule out the presence of cancer.

As stated by National Breast Cancer Foundation Inc., “A diagnostic mammogram can help determine if these symptoms are indicative of the presence of cancer. As compared to screening mammograms, diagnostic mammograms provide a more detailed x-ray of the breast using specialized techniques. They are also used in special circumstances, such as for patients with breast implants.”

This form of mammogram will take longer than the average screening mammogram. The doctor will use X-rays to examine the breast further than they would in a screening mammogram. During this test the breasts will be compressed firmly between flat plates. A diagnostic mammogram will result in additional views of the breast for the doctor to evaluate to determine the root cause of the abnormality.


If you are still unsure if a screening mammogram or a diagnostic mammogram is right for you, don’t worry. Consult with your physician and they will know the best course of action.

About Dr. Drake

If you are in the Houston, Texas area and are ready to learn more about or undergo a mammogram, look no further than Dr. Natalie Drake. Not only does Dr. Drake have an extensive and impressive background in women’s health, she also specializes in menopause treatment and management. And this extends beyond just her medical practice.

She believes in supporting her patients throughout their whole journey. Dr. Drake is involved with various fund raising events to combat breast cancer and support cancer survivors.