What to expect during your mammogram

If you have a mammogram on your calendar, congratulations! You’re taking a huge step to protect your health. In fact, mammograms are among the safest and most accurate screenings available in the United States. Since 1990, this test has lowered deaths from breast cancer by nearly 40 percent. 

That said, it helps to go into your exam with a bit of expert advice, even if this isn’t your first mammogram. The answers to the following questions will help you feel prepared.

What is a mammogram?

It’s simply an X-ray image of the breast that’s used for screening and diagnosis. Over time, these pictures serve as a baseline reference point for doctors to compare changes. According to the American Cancer Society, a mammogram can spot changes in your breast years before you’d ever have physical symptoms. Keeping up with your recommended screenings is the best way to protect yourself, as mammograms catch about seven out of eight breast cancer cases.

What happens during your mammogram?

The exam takes less than half an hour. Each breast is compressed onto a plate to allow for better visualization. The pressure also prevents motion that could blur the image. You’ll be asked to hold your breath and remain motionless while the image is processed. Most full tests involve several pictures taken from above and from the sides of both breasts. 

Once the images are done, you’ll be asked to wait while the technician confirms that the pictures are clear. Occasionally, dense breast tissue “folds” on itself and creates an inexact image, requiring an additional picture. This extra step isn’t cause for alarm. Your technician just wants a direct image.

When should you get your first mammogram?

The American Cancer Society recommends the following frequencies for mammograms for women who are at average risk:

• Women ages 40 to 54: annually (optional up to age 44)
• Women ages 55 and up: annually, or every other year

If you are at high risk, your screening plan will have more steps and will start sooner. Being high risk could mean that you have any of the following:

• A first-degree relative (a parent, sibling, or child) with breast cancer
• A second-degree relative (an aunt, uncle, or grandparent) with breast cancer
• A clear genetic risk, especially the BRCA1, BRCA2, or other gene mutations

What should you consider when scheduling your mammogram?

As your mammogram approaches, here are four things you should know:

1. If you’re premenopausal, plan your appointment around your menstrual cycle. You may experience less discomfort and tenderness if you’re screened the week after your period.  
    
2. Try to schedule the test early in the day. You can’t use deodorant, powder, lotion, or ointment around the chest area beforehand, so you may want to start your day with the screening, before you’ve applied anything to your skin in that region. Deodorants, creams, powders, and lotions often contain substances that can be mistaken for white spots called calcifications on your X-ray. This could lead to unnecessary testing. 
    
3. If this isn’t your first mammogram but you’re going to a new facility, arrange to have your prior mammograms sent in advance. You can also request and bring a CD of the images. Having your previous results gives the radiologist a basis for comparison. 
    
4. Understand the screening options. Conventional mammograms used regular X-ray film. Today, there are other options: 2D digital mammography, which stores its findings on a digital chip, and 3D, which combines multiple images together for reconstructions that visualize the entire breast. Many studies have found that 3D mammography may lower the chance of being called back for follow-up testing. And it may even find more breast cancers, especially in women with denser breast tissue. As always, talk to your doctor about which mammogram type is right for you. 

How should you prepare for your visit?

There’s no major prep involved for a mammogram. Just plan to wear comfortable clothes that allow you to undress easily, skip the deodorant and lotion, and avoid wearing necklaces or dangling jewelry that day.

You’ll want to let your provider know if you have noticed any recent changes in your breasts, are at a high genetic risk of breast cancer, have breast implants, are breastfeeding, or may be pregnant. It’s also important to tell your provider if you have any skin abnormalities, like moles, skin tags, or scars.

Also, be sure to discuss timing with your doctor, as it’s recommended that you wait at least six weeks to get a mammogram after receiving any COVID-19 vaccination. 

What do you need to know about following up?

You did it! You received your mammogram. So now what?

• Getting your results. By law, all patients must receive written exam results within 30 days. Most patients hear from their doctor far earlier. If not, call and ask for the findings. Increasingly, they’re being shared almost immediately. That’s a big plus for those who suffer from post-test anxiety. 
   
• Ask questions. If you have any concerns, raise them with your doctor. Also, make sure you’re informed about the basic characteristics of your breasts. There are four categories of mammographic density (breast-tissue thickness). As of September 10, 2024, any mammogram reports sent to patients in the United States will be required to include breast density, according to the American Cancer Society. Until then, the requirements differ from state to state.
   
• Don’t panic if your results are inconclusive. Did you receive an inconclusive result or were you asked to come in for a follow-up visit? Stay calm: This just means that more information is needed. In fact, fewer than 10% of women called back are found to have cancer. In most cases, the issue is related to the quality of the pictures themselves. And even when something is detected, it may be a harmless cyst, dense breast tissue, or a benign calcium deposit rather than anything serious.

Once you have the likely all-clear, remember to track your breast health on your own. Keep your regular wellness appointments, pay attention to any changes, and inform your doctor if something concerns you. Keep in mind that the sooner breast cancer is detected, the sooner action can be taken. And always remember that any preventive screening, such as a mammogram, could save your life. 

A mammogram isn’t a test you can study for. But these facts can help you feel prepared, whether it’s your first exam or your fifth.