Mammograms: what to expect

What is a mammogram? A screening mammogram can help detect early signs of breast cancer, which may allow for more treatment options and improved prognosis. Mammograms cannot determine if you have breast cancer with a single test, and potential cancer will require further examination.

Here is what you can expect from your mammogram, including HCA Healthcare's global cancer institute, Sarah Cannon, recommended mammogram screening schedule, how to prep for your mammogram, information on high risk, and answers to commonly asked questions about mammograms.

Types of breast screening

• Mammogram: The patient stands in front of the mammography unit, and a technologist uncovers the breast to be scanned and places it on a clear plastic plate. Then a second plate lowers until the breast is pressed between the two plastic plates. Images are taken of each breast from the front and the side. Tip: If your breasts are tender or swollen due to your menstrual cycle, consider rescheduling your mammogram to the week following your menstrual cycle.
• Breast Magnetic Resonance Imaging (Breast MRI): Used for women at higher risk of breast cancer, as a breast cancer staging tool, or to identify lesions in women who have already been diagnosed with breast cancer. The breast MRI creates three-dimensional, detailed images of the breast using a magnet connected to a computer. Sometimes the doctor may order a Breast MRI with contrast, meaning that a contrast dye will be injected into your body through an IV. Tip: Even if you are at higher risk, you still need to have regular mammograms in addition to any other recommended screening tests.
• Breast Ultrasound: Generally used for women with lumps or abnormalities identified during a breast self-exam, clinical breast exam, or mammogram. The test bounces sound waves off the breast tissue to create a picture called a sonogram. You'll lie down on a table, raise your hands above your head, and have a water-based gel applied to the area. Then, the radiologist or sonographer will run the transducer over your breast. Tip: A breast ultrasound does not replace regular mammograms.

Recommended mammogram screening schedule

• Average risk of breast cancer: Annual mammogram beginning at age 40
• High risk of breast cancer: Women should talk with their physicians regularly starting as early as age 25 about their individualized risk for breast cancer, as higher risk women may benefit from genetic counseling or early screening.

What is high risk?

• Prior personal history of breast cancer, or other abnormalities in the breast tissue
• A high proportion of dense breast tissue instead of fatty tissue
• Previous breast exposure to radiation therapy before age 30
• Pregnancy after age 30, or no pregnancy at all
• Absence of breastfeeding
• Overweight, particularly after menopause
• Increased exposure to estrogen, first period before age 13, menopause after age 51, prolonged hormone replacement therapy
• Previous biopsy results that indicate atypical hyperplasia, lobular carcinoma in situ, or radial scar formation

Prep for your appointment

Dress for comfort. Depending on the type of mammogram, you may only need to remove your top. If you are having a mammogram, don't wear deodorant, perfume, or powder. However, if you forget, many centers provide cleansing cloths for this purpose.

Source: Centers for Disease Control and Prevention

Mammogram Q&A

I'm pregnant or breast-feeding and due for a test. Should I wait?

If you are pregnant, you should not undergo a mammogram because of possible danger to the fetus. If your gynecologist or obstetrician feels it is important to have a breast screening test during your pregnancy, a breast ultrasound will be ordered.

If you are breastfeeding, your tissues may appear more dense than usual, making it harder for the radiologist to interpret the results.

I have a breast implant. Can I still get a mammogram?

While it is safe to have a mammogram when you have a breast implant, be sure to tell the technologist before the procedure since the machine may require special adjustment for the best possible images.

What else should I know?

You should always receive the results of your mammogram. If there are any abnormalities, your doctor may refer you to a breast specialist or a surgeon for more tests or evaluations. If the results are normal, continue to follow your recommended schedule for the next mammogram.

It is important to know that the information in this post, including Sarah Cannon’s recommendations for screening, is accurate as of the original publishing date of 8/2020.