Name of the Procedure:

Diagnostic Mammography, including computer-aided detection (CAD) when performed; bilateral
Common names: Diagnostic mammogram, Bilateral diagnostic mammogram
Technical term: HCPCS Code G0204

Summary

A diagnostic mammography is an X-ray imaging procedure specifically designed to examine the breast tissues. It is used to diagnose unusual findings or symptoms, such as lumps or pain. The procedure includes computer-aided detection (CAD) to enhance the accuracy of the results by highlighting potential areas of concern.

Purpose

Medical conditions/problems addressed:

• Breast lumps, pain, nipple discharge, or other unusual symptoms.
• Follow-up on abnormal results from a screening mammogram or clinical exam.

Goals/expected outcomes:

• Accurate diagnosis of breast abnormalities.
• Early detection of breast cancer or other conditions.

Indications

Symptoms or conditions:

• Detection of unusual lumps or masses.
• Persistent breast pain.
• Nipple discharge or changes.
• Abnormal results from a previous mammogram.

Patient criteria:

• Women with persistent breast symptoms.
• Patients with a history of breast cancer.
• Individuals with significant findings from a screening mammogram.

Preparation

• Pre-procedure instructions:
  • Avoid using deodorants, powders, or lotions on the breast area on the day of the exam.
  • Wear a two-piece outfit for ease of undressing from the waist up.
• Diagnostic tests/assessments:
  • Prior mammogram images for comparison, if available.
  • Health history review.

Procedure Description

1. The patient undresses from the waist up and wears a provided gown.
2. The patient stands or sits near the mammography machine.
3. The technician places the breast on a flat surface and compresses it with a paddle to spread the tissue for clear imaging.
4. X-ray images are taken from multiple angles.
5. Computer-aided detection (CAD) software analyzes the images, marking areas that need further evaluation by the radiologist.
6. The process is repeated for the other breast.

Tools, equipment, or technology used: Mammography machine, CAD software.

Anesthesia/sedation: Not typically required.

Duration

The procedure usually takes about 10 to 20 minutes.

Setting

Performed in a hospital radiology department, outpatient clinic, or specialized imaging center.

Personnel

• Radiologic technologist conducts the imaging.
• Radiologist interprets the results.

Risks and Complications

• Common risks: Discomfort or pain during breast compression.
• Rare risks: Minor radiation exposure, false positives/negatives.

Possible complications and management: False positives may lead to unnecessary follow-ups; these can be managed with additional imaging or biopsies if required.

Benefits

• Expected benefits: Early and accurate detection of breast abnormalities.
• Timing: Results are typically available within a few days, enabling quick follow-up if needed.

Recovery

• Post-procedure care: No specific post-procedure care required.
• Expected recovery time: Immediate return to normal activities.
• Restrictions/follow-up: Follow your healthcare provider's instructions for any further tests or appointments.

Alternatives

• Other treatment options:
  • Screening mammogram: less detailed but useful for routine screening.
  • Ultrasound: used for further evaluation of specific areas.
  • MRI: detailed imaging, used for high-risk patients or complex cases.

Pros and cons compared to the described procedure:

• Screening mammograms are less invasive but not as detailed.
• Ultrasounds are non-radiative but may miss tiny lesions.
• MRIs provide detailed imaging but are more expensive and time-consuming.

Patient Experience

During the procedure: Mild discomfort from breast compression.

After the procedure: Minimal to no discomfort. Pain management is typically not necessary as discomfort subsides quickly after compression ends.

Comfort measures: Communicate with your technologist if you need breaks or adjustments during the procedure.