Overview of Diagnostic Breast Imaging
Diagnostic breast imaging is recommended for patients who have breast symptoms or when something seen on a screening exam needs a closer look. These tests provide more detailed images to help your care team understand what is causing your symptoms and determine any needed next steps.
Types of Diagnostic Breast Exams We Offer
- Recommended for patients experiencing symptoms, with focused imaging of the specific area of concern.
- The radiologist reviews the images in real time and determines what if any additional or specialized views are needed as you are being imaged. You will speak with our dedicated breast imaging radiologists at the end of each diagnostic appointment to get the results.
- Commonly used in addition to a mammogram to further evaluate a symptom or finding seen on a mammogram
- Frequently performed alongside a diagnostic mammogram for a more complete assessment
- This exam may be recommended to provide additional clarity based on your symptoms, prior imaging or clinical history. It is commonly used for:
- Patients with a new or current breast cancer diagnosis
- Monitoring response to neoadjuvant chemotherapy (treatment given before surgery)
- Identifying a primary tumor when breast cancer is present but not detected on other imaging
- Evaluation of breast implant integrity
Importance of Prior Imaging
If you've had breast imaging at another facility, sending your prior scans to us before your appointment helps your care team get a more complete picture of your breast health. Having prior images available for comparison allows your radiologist to identify changes over time and provide the most accurate interpretation of your results and avoid unnecessary imaging and/or biopsies.
Sharing Prior Imaging
If you have had prior imaging that was done outside of Weill Cornell Medicine, Columbia University, or NewYork-Presbyterian, please let us know when scheduling your appointment. We’ll follow up with instructions on how to share your previous imaging with us.
What to Expect During a Diagnostic Visit
A diagnostic visit is more detailed than a routine screening exam. While the technologist is obtaining the images, a radiologist will be reviewing them in real time to determine whether additional mammography or ultrasound views are needed. These images are performed during the same appointment to ensure a complete evaluation.
Once all imaging is complete, the radiologist will discuss findings with you directly and walk you through any recommended next steps so you can leave your appointment with a clear understanding.
Understanding Your Diagnostic Report
Your report will include something called a BI-RADS score: a standardized system radiologists use to describe what they see on your imaging and to help guide the next steps. Here's a quick guide:
BI-RADS 0 – Incomplete: We need additional images before we can make a final assessment. This is common and does not necessarily mean anything is wrong.
BI-RADS 1 – Negative: The exam looks normal with no concerning findings. Continue with routine screening schedule.
BI-RADS 2 – Benign: A non-cancerous finding was seen, such as a cyst or calcification. These findings are common and not harmful. Continue with routine screening schedule.
BI-RADS 3 – Probably Benign: A finding was seen that is very likely non-cancerous (greater than 98% chance of being benign). We typically recommend follow-up imaging in about 6 months to confirm there are no changes over time.
BI-RADS 4 – Suspicious: A finding was identified that requires further evaluation, often with a biopsy. While many biopsies do not result in a cancer diagnosis, additional testing is important to better understand the finding.
BI-RADS 5 – Highly Suspicious: The finding has a high likelihood of cancer. A biopsy will be strongly recommended so we can make an accurate diagnosis and discuss the next steps.
BI-RADS 6 – Known Cancer: Cancer has already been confirmed by biopsy. Imaging is being used to help guide treatment planning and care.
Your radiologist will review your results with you, explain what your BI-RADS score means and discuss any recommended next steps so you feel informed and supported throughout the process.
Your report will be automatically shared with you and your referring provider typically within 24–48 hours. You can view your images and reports anytime through our patient portal, Connect. Use this guide to get started.
Understanding Your Next Steps
In some cases, your imaging results will provide reassuring news and no further action will be needed beyond routine follow-up. In others, your radiologist may recommend further testing, including a biopsy, to better understand the findings.