Imaging Indications for Providers

To expedite patient care and limit wait times, please call the Breast Care Center if there are questions regarding orders. Thank you for allowing us to serve your patients.

Diagnostic Mammography Indications

  • To evaluate clinical symptoms that may include, but are not limited to a palpable abnormality, focal pain, nipple discharge or skin changes.
  • A finding detected on screening mammography that requires further imaging evaluation.
  • Short-interval follow-up for probably benign radiographic findings as defined by the ACR Breast Imaging Reporting and Data System (BI-RADS®).
  • Asymptomatic patients previously treated for breast cancer may undergo screening or diagnostic mammography at the discretion of the facility.

Please instruct patient to bring prior mammogram images to their appointment, or they may bring to the Breast Care Center anytime for uploading prior to their appointment (disc or hard copy). The radiologist must have prior images for comparison or the patient will be rescheduled.

To expedite patient care, all diagnostic orders should include an order for ultrasound if indicated.

Please include laterality in the diagnosis.

Screening Mammography Indications

  • ACR recommends screening mammograms annually for asymptomatic women age 40 and older who are at average risk for breast cancer.
  • There is no defined upper age limit at which screening may not be beneficial.
  • Mammographic screening should be considered as long as the patient is in good health and willing to undergo additional testing, including biopsy, if an abnormality is detected.
  • Asymptomatic women under age 40 who are at increased risk for breast cancer.
    • Woman with known mutation or genetic syndrome with increased breast cancer risk: yearly starting by age 30, but not before age 25.
    • Untested woman with a first-degree relative with known BRCA mutation: yearly starting by age 30, but not before age 25.
    • Woman with a 20 percent or greater lifetime risk for breast cancer based on breast cancer risk models: yearly starting by age 30, but not before age 25, or 10 years earlier than the age at which the youngest first-degree relative was diagnosed, whichever is later.
    • Woman with a history of chest (mantle) radiation received between the ages of 10 and 30: yearly starting 8 years after the radiation therapy, but not before age 25.
    • Woman with biopsy-proven lobular neoplasia, atypical ductal hyperplasia (ADH), ductal carcinoma in-situ (DCIS), invasive breast cancer or ovarian cancer: yearly from time of diagnosis, regardless of age.
  • Women with breast implants should undergo screening
    • Asymptomatic women with breast implants may undergo screening mammography. Implant rupture is a very rare complication of mammography.

Breast Sonography Indications

Appropriate indications for breast sonography include, but are not limited to:

  • Evaluation and characterization of palpable masses and other breast-related symptoms such as nipple discharge or focal pain
  • Evaluation of abnormalities detected on mammography or breast magnetic resonance imaging (MRI)
  • Initial imaging evaluation of palpable breast masses in patients under 30 years of age who are not at high risk for development of breast cancer and in lactating and pregnant women
  • Treatment planning for radiation therapy

Please instruct patient to bring prior mammogram images to their appointment, or they may bring to the Breast Care Center anytime for uploading prior to their appointment (disc or hard copy). The radiologist must have prior images for comparison or the patient will be rescheduled.

Patients over 30 should be scheduled for a diagnostic mammogram with ultrasound if indicated. Male patients require diagnostic mammogram order unless they are younger than 20.

If it has been more than six months since the most recent mammogram, the patient should be scheduled for a diagnostic mammogram, with ultrasound if indicated.