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Healthy Body


Screening vs. Diagnostic Mammograms
October 2023

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By Melissa Chefec

The American Cancer Society (ACS) reports, “Breast cancer is the most common cancer in women in the United States, except for skin cancers. Breast cancer accounts for about 30% (or 1 in 3) of all new female cancers each year.

Worldwide those numbers are equally staggering. According to the National Institutes of Health (NIH), there were over “2.3 million new cases and 685,000 deaths in 2020,” making breast cancer the most commonly diagnosed cancer in the world.

In order to be able to spot a problem in the early stages, millions of women undergo mammograms every year. Mammograms are done at imaging centers or hospitals and are the most commonly used tool to detect breast cancer in women. These x-rays of the breast are considered the best way to find breast cancer early and when it’s easier to treat. Some women schedule the imaging test to screen for breast cancer, while others have mammograms for diagnostic purposes. What’s the difference?
It’s a common question, says Robert Segal, M.D., co-founder and CEO of LabFinder, an online scheduling platform for patient laboratory and radiology appointments.
“Screening mammograms are performed in women who don’t have signs of breast cancer, but want to catch it early if it develops,” Dr. Segal explains. “Diagnostic mammograms, on the other hand, are performed if a woman has symptoms of breast cancer, such as a lump or changes in the skin or thickness of breast tissue. Mammogram testing is often repeated in these women to diagnose the disease or rule it out.”
Mammograms are the primary form of breast cancer screening that women undergo, boasting highly effective results. Screening mammograms lower breast cancer death rates in women 40 and older by 40% when compared with no screening, according to the National Institutes of Health.

Additional Imaging Tools
​

Signs and Symptoms of Breast Cancer (Mayo Clinic)
  • A breast lump or thickening that feels different from the surrounding tissue
  • Change in the size, shape or appearance of a breast
  • Changes to the skin over the breast (such as dimpling)
  • A newly inverted nipple
  • Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
  • Redness or pitting of the skin over your breast, like the skin of an orange
​As useful as mammograms are, however, they’re only part of the picture if a woman is considered at higher risk of breast cancer or once the disease is suspected. Other imaging tools, including ultrasound and breast MRI (magnetic resonance imaging), may be combined with mammography to help diagnose breast cancer since each tool offers specific advantages, Dr. Segal says.
 
Dr. Segal offers a breakdown of each tool, as well as its pros and cons.

​Mammograms: Digital mammography captures views from several angles of the breast using low-dose x-rays. Areas appearing white in the resulting images represent glandular tissue, while fatty areas are depicted in black. Mammogram images can be harder to accurately read in women with dense breasts, which means they have a higher proportion of glandular and connective tissue compared to fat. Women with dense breasts are at higher risk of breast cancer, but both dense tissue and cancer show up as white areas on mammograms.
 
Ultrasound: High-frequency sound waves create images of breast tissue during an ultrasound exam. This imaging tool is considered a supplemental screening method in women with dense breasts, since cancerous areas will stand out by showing up as black on ultrasound, and not white as with mammograms. But ultrasound isn’t typically used as a stand-alone test because it has a high false-positive rate, so it’s usually combined with mammography.
 
MRI: This imaging blends radio waves with a powerful magnet, and contrast fluid is injected into patients to help “light up” potential cancerous areas. MRI is considered a highly powerful way to detect and diagnose breast cancer, but it’s not generally used for screening purposes, since it’s expensive and not widely available.
 
Get Testing When Needed
 
Dr. Segal helped establish LabFinder.com on the premise that medical tests should be readily accessible and affordable and provide quick results to patients. Screening recommendations vary, but most agree that women 40 and older should consider getting mammograms once every year or two for breast cancer detection. Women should ask their doctors about breast cancer screening and to seek help scheduling an appointment.
 
“Any woman who is experiencing possible breast cancer symptoms should immediately ask for a mammogram and/or other breast imaging to confirm a breast cancer diagnosis or rule it out,” Segal says. 

Robert Segal M.D. is co-founder of LabFinder, a consumer-facing platform that transforms the patient experience through seamless lab & radiology testing, guiding patients to conveniently located testing centers, handling appointment bookings, offering telehealth services, and allowing patients to review their test results all in one place. He is board-certified in cardiovascular disease, echocardiography, and nuclear cardiology. He is founder of Manhattan Cardiology and Medical Offices.

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Additional Resources:

National Cancer Institute
Centers for Disease Control

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