
Do you know the difference between a screening mammogram and a diagnostic mammogram? Mammograms are x-ray images of your breast, used to help doctors detect the signs of breast cancer. In fact, mammography can detect breast cancer as early as two years before a lump can be felt by you or your doctor. One in eight women will develop breast cancer in their lifetime, which makes mammogram screenings crucial for the early detection of breast cancer, when it’s most treatable. Although similar tests, there is a big difference between a screening mammogram and a diagnostic mammogram.
A Screening Mammogram is:
• Recommended every year beginning at age 40
The American College of Radiology (ACR) and Society of Breast Imaging (SBI) both recommend that women start getting annual mammograms at age 40; however, some are at an increased risk because of family history, physical factors, and more. Women should consult their doctor about when to start screening and how often to get screened.
• Started earlier for women with a family history of breast cancer
According to the American Cancer Society, having a first-degree relative with breast cancer nearly doubles a woman’s risk for developing breast cancer. Although it is extremely common for those with breast cancer to have a family history, most women who get breast cancer do NOT have a family history, which is why regular screening mammograms are an essential diagnostic tool for the disease.
• The best way to detect breast cancer early
Finding breast cancer in its early stages makes it easier to treat. Finding breast cancer through screening mammography before a lump can be felt increases your survival likelihood and also allows for less invasive treatment options. We can’t prevent breast cancer, so catching it early is crucial.
• Covered by insurance
Because of their life-saving utility, insurance companies consider screening mammograms a medically-necessary preventative service. In fact, most cancer screenings are covered by insurance. Most insurances cover screening mammograms starting at age 40.
• No referral needed
Although some imaging tests require a provider’s referral, routine mammogram screening does not.
A Diagnostic Mammogram is:
• Performed if a patient has a lump or pain in the breast
Although mammograms are the easiest way to catch cancer early, before symptoms develop, they can also be used to diagnose breast cancer after a lump is felt. If you notice symptoms of breast cancer such as a lump, abnormal nipple discharge, change in breast size, and more, contact your provider to see if you require further testing.
• Performed if a screening mammogram shows abnormalities
Abnormal mammogram results could include small white spots (calcifications) and lumps or tumors (masses). If you receive abnormal results, it’s a good idea to follow-up with your doctor on what to do next.
• May involve an ultrasound done by a radiologist
Ultrasounds are not typically used for screenings because they can often miss the first indicators of breast cancer; instead, they are helpful for diagnostic purposes. Ultrasounds are usually performed to determine if a mass in the breast is really a cyst filled with fluid or a solid tumor.
• Subject to co-pay or deductible payment owed by the patient
Depending on your insurance plan, your diagnostic mammogram might be subject to co-pay or deductible.

About A. Janae Johnson, MD
A. Janae Johnson, MD is a board certified radiologist with additional fellowship training in breast imaging, practicing at TPMG Imaging and Breast Centers in Newport News and Williamsburg. A full-time breast imaging specialist, Dr. Johnson has the knowledge, expertise, and state-of-the-art equipment to detect and diagnose breast cancer in its earliest stages. She is immensely proud of the TPMG Imaging and Breast Center earning the prestigious designation of “Breast Center of Excellence” by the American College of Radiology.