What is the difference between digital mammogram screening and diagnostic mammography?

From the Guidelines

The primary difference between digital mammogram screening and diagnostic mammography is their purpose and application, with screening mammograms serving as a routine examination for asymptomatic women and diagnostic mammograms being more detailed and focused on evaluating specific symptoms or findings. The purpose of screening mammograms is to detect breast cancer early in women with no symptoms, typically involving two standard X-ray images of each breast and recommended annually for women over 40 or based on risk factors 1. On the other hand, diagnostic mammography is performed when symptoms such as a lump, pain, or nipple discharge are present, or when screening mammograms reveal an abnormality, and it involves additional specialized views and magnification of suspicious areas 1. Some key points to consider include:

• Diagnostic mammograms are more comprehensive and take longer to perform than screening mammograms
• Diagnostic mammograms are immediately reviewed by a radiologist who may recommend further testing
• Digital breast tomosynthesis (DBT) may be used in place of traditional diagnostic mammographic imaging in certain situations, and it has been shown to increase cancer detection rate and decrease recall rate compared to digital mammography alone 1
• The American College of Radiology recommends annual screening mammography beginning at 40 years of age for women at intermediate risk, and screening DBT in average-risk women each year beginning at 40 years of age 1
• The distinction between screening and diagnostic mammograms is important because diagnostic mammograms are tailored to investigate particular symptoms or findings, whereas screening mammograms serve as a preventive measure for asymptomatic women. It's also worth noting that the evidence suggests that DBT can be useful in the diagnostic setting, improving lesion characterization in non-calcified lesions compared to conventional mammographic workup 1. Overall, the choice between digital mammogram screening and diagnostic mammography depends on the individual's symptoms, risk factors, and medical history, and should be guided by the most recent and highest-quality evidence.

From the Research

Digital Mammogram Screening vs Diagnostic Mammography

The key differences between digital mammogram screening and diagnostic mammography lie in their purposes, procedures, and outcomes.

• Purpose:
  • Digital mammogram screening is used for early detection of breast cancer in asymptomatic women, typically as part of a routine check-up 2, 3.
  • Diagnostic mammography is utilized when a woman has symptoms such as a lump, pain, or nipple discharge, or when an abnormality is detected during a screening mammogram 4.
• Procedure:
  • Screening mammograms usually involve two views of each breast and are designed to detect breast cancer at an early stage before symptoms develop 2.
  • Diagnostic mammograms are more detailed and may include additional views or specialized imaging to evaluate a specific area of concern in the breast 4, 5.
• Outcomes and Benefits:
  • The effectiveness of screening mammography in reducing breast cancer mortality has been established for women over 50, but its benefit for women aged 40-49 is still debated 3, 5, 6.
  • Diagnostic mammography helps in the accurate diagnosis of breast abnormalities, guiding treatment decisions 4.
• Risks and Considerations:
  • Both screening and diagnostic mammography carry risks such as false positives, false negatives, and exposure to radiation 5, 6.
  • The decision to undergo screening or diagnostic mammography should be based on individual risk factors, age, and health history, considering the potential benefits and harms 2, 5, 6.