Diagnostic Mammography

Diagnostic mammograms provide useful information in the assessment of breast health. They often are ordered as a follow-up to regular screening mammograms so that physicians might further evaluate areas of concern. Diagnostic mammograms also are used for patients who are experiencing a new breast symptom.


About Diagnostic Mammography

At ARA Health, we utilize 3D technology for both screening and diagnostic mammograms. The most advanced screening technology available, it uses low-dose X-rays to produce multiple images of the breast from different angles, allowing our expert physicians to view the breast in layers. Diagnostic mammograms may include extra views of the breast that were not included in the initial screening mammogram, allowing for closer evaluation of an area of concern. Similarly, women who are experiencing a new breast symptom, like a lump, nipple discharge, or changes in the breast skin, often will have a diagnostic mammogram instead of a screening mammogram so that the symptom may be explored in greater detail. It also is common for physicians to order diagnostic mammograms as the standard screening method for women who have previously been treated for breast cancer.


For some patients, physicians will request additional imaging, like breast ultrasound, breast MRI, or even needle biopsy of the breast. Keep in mind that these exams are more likely to rule out breast cancer than to end with a cancer diagnosis! Regardless of the outcome, you are in very capable hands with ARA Health. Our physicians are subspecialized in breast imaging, which means they are true experts in their field. And as part of our commitment to helping each patient achieve optimal breast health, we offer breast density and breast cancer risk assessments, which provide useful information in the creation of personalized screening strategies.

You have questions. We have answers.

Below you'll find answers to some of the questions we are commonly asked by patients. Please contact our ARA Cares Coordinator at (828) 436-5500 with any additional questions or concerns.

What is the difference between a screening mammogram and a diagnostic mammogram?

Screening mammograms are used for women who have no symptoms of breast disease. They do not require a physician’s referral and are usually covered by insurance at 100%. Diagnostic mammograms do require a physician’s referral, and costs are applied to a patient's insurance deductible. Diagnostic mammograms are used for specific reasons:

  1. If radiologists have concerns about a particular area on a screening mammogram, a diagnostic mammogram can be ordered to further evaluate.
  2. If a patient has a new breast concern, like a lump, nipple discharge, or changes in the breast skin, referring physicians will order a diagnostic mammogram. 
  3. If a patient has previously been diagnosed with breast cancer, she may receive diagnostic mammograms for several years post-treatment.
Can I schedule a diagnostic mammogram myself?

Diagnostic mammograms require a physician’s order and cannot be scheduled directly by the patient. Our ARA Cares Coordinator can answer your questions or help you obtain a physician’s order.

When should I begin annual mammograms?

Experts agree that beginning breast screening at age 40 saves the most lives; however, women who have an increased risk of developing breast cancer should begin them earlier. Understanding your personal risk for developing breast cancer can empower you to make informed decisions about your own breast health. ARA Health's subspecialized breast radiologists, along with the American College of Radiology and Society of Breast Imaging, recommend:

Age 30: All women should undergo a breast cancer risk assessment (especially Black women and those of Ashkenazi Jewish decent).

Age 40: All women should have a 3D screening mammogram and plan to repeat them every 12 months (not just every calendar year).

How do I prepare for a diagnostic mammogram?

Regarding patient experience, a diagnostic mammogram is very similar to a screening mammogram – simple and quick, requiring little preparation. It is helpful to wear a two-piece outfit so that just your top may be removed. Please do not wear lotion or deodorant, as these products may damage our equipment.

What can I expect during a diagnostic mammogram?

In most cases, the entire exam takes just 20 to 30 minutes. A female technologist will explain the procedure before it starts. You will undress from the waist up, putting on a gown that opens in the front. During the exam, the technologist will position each breast in the scanner. Your breasts will be compressed, or flattened, which may be uncomfortable, but not painful. Compression is essential to producing clear images of the breast's tissue at a lower X-ray dose, and each compression lasts less than a minute. When the exam is complete, one of our subspecialized radiologists will discuss the findings with you before you leave.

When will I receive the results?

Diagnostic mammograms are read immediately by one of our subspecialized radiologists. He or she will discuss the results with you, as well as any necessary follow-up, before you leave the appointment.

What should I know about breast cancer?
  • 75-85% of women diagnosed with breast cancer have no family history.
  • One in eight women will be impacted by breast cancer in her lifetime.
  • When caught early, the five-year survival rate of breast cancer is 99%.
  • Breast cancers found in women under age 50 often are more aggressive, making screening mammography an important health tool for women in their 40s.
  • The cancer incidence rate increases with age, making annual mammography even more important to women ages 50+.
  • Men can also get breast cancer, although it is much less common than it is for women.
What increases my risk for breast cancer?

All women are at risk for developing breast cancer. The two biggest risk factors are being female and getting older. Other factors that increase a person's risk include:

  • being overweight or obese
  • having a sedentary lifestyle
  • drinking more than one alcoholic drink a day
  • exposure to high-dose radiation, particularly before age 30 (e.g. radiation therapy)
  • family history of breast cancer
  • inherited genetic mutations
  • using hormone therapy after menopause
What decreases my risk for breast cancer?

Several factors can decrease a person's risk of breast cancer, including:

  • maintaining a healthy weight
  • exercising regularly, on average 3-4 hours a week
  • one or more full-term pregnancies
  • first full-term pregnancy before age 25
  • breastfeeding for more than 15 months (total months across all children)
  • menopause before age 50
What is breast density?

Breast density measures the amount of fatty, glandular, and fibrous tissue in the breast. Dense breasts have more glandular and fibrous tissue than fat, and the only way to determine this is through a mammogram. Radiologists use a scale approved by the American College of Radiology. Women who have breast density of level A or B have more fatty tissue, while women with breast density of level C or D have more glandular and fibrous tissue, which means they have dense breasts. Dense tissue makes breast cancer more difficult to detect on a mammogram and is also a risk factor for developing breast cancer. Approximately 40% of women over age 40 have dense breast tissue. Women who have been identified as having category C or D density on a mammogram may sit down with our clinical specialist at our Breast Cancer Risk Assessment Clinic to discuss in detail what this means and how to best address it with a supplemental screening plan.