Getting an annual mammogram is an essential step in staying healthy. Women with an average risk for breast cancer typically should begin such screening at age 40, according to guidelines.

"A mammogram is an X-ray of the breast that can help detect early-stage breast cancers that are still too small to be palpated," says Dr. Ainel Sewell, a breast radiologist at Houston Methodist. "Catching breast cancer this early is critical since it provides more treatment options and greatly improves prognosis."

What else do you need to know about this important screening tool? Among other commonly asked questions, many women wonder whether it matters where you get your mammogram.

Dr. Sewell says, "It does."

Here are five criteria to consider as you make your choice:

1. Specialization in breast imaging

You'll have many options when deciding where to get your annual mammogram, including mobile units, freestanding clinics, general imaging facilities and centers that specialize in breast imaging, like one of the Houston Methodist Breast Care Centers.

Dr. Sewell recommends centers that specialize in breast imaging. Such centers offer comprehensive breast care, the importance of which cannot be understated.

"At a comprehensive breast care center, screening for breast cancer — which includes follow up on abnormal findings — is all we do," explains Dr. Sewell. "Every type of procedure is made available. We have access to the full array of technology needed to thoroughly assess breast tissue and diagnose breast cancer as early as possible."

This isn't always the case at general imaging facilities or other clinics offering screening mammograms.

Many women also prefer the experience at a specialized breast imaging center, since the environment and care are geared entirely toward making a mammogram appointment as stress-free and comfortable as possible.

2. Fellowship-trained breast radiologists

It's best to choose a facility that boasts board-certified, fellowship-trained radiologists specializing in breast imaging.

"Rather than a general radiologist that dabbles in multiple disciplines, a breast radiologist focuses solely on mammograms and detecting subtle changes in breast tissue," explains Dr. Sewell. "This level of sub-specialization is critical for early detection."

You might think breast masses should be easy to see on a mammogram, but this often isn't the case. Detecting early-stage breast cancer requires being able to spot the slightest changes.

"Sometimes this is as subtle as skin thickening on one side or tissue that looks more dense than previous years," says Dr. Sewell. "Having additional training and specialized expertise means we're well-suited to catching things that others might overlook."

3. Also offers diagnostic mammograms and biopsy

When scheduling a screening mammogram, make sure the facility also offers diagnostic mammograms and biopsies. This becomes important should you get called back for additional workup.

"If something suspicious is spotted on a screening mammogram, a diagnostic mammogram is used to verify whether the finding is real," says Dr. Sewell. "We might also perform a breast ultrasound at this time."

But not all facilities offer diagnostic mammograms, breast ultrasounds and specialized radiologists on site. When this is the case, you may have to go somewhere else for any follow-up care needed, or you may not actually see the radiologist in person.

"Unfortunately, the patient often has to do a lot of this legwork," warns Dr. Sewell. "They have to get a physician referral, and they're also in charge of collecting their images and delivering them to a comprehensive breast care center. It can be a big headache and lead to a delay in care, during a time when a patient is anxious and looking for answers quickly."

The advantage of starting at a specialized breast care center is that all of the expertise and technology that might be needed is offered at one place, providing both convenience and peace of mind.

4. Uses up-to-date equipment and performs 3D mammograms

As you research your options, make sure you're looking at facilities that use 3D mammograms. This is a highly efficient and accurate digital technology that helps identify very small tumors. Most facilities offer 3D mammograms these days, but it's important to do your homework and be sure.

"Avoid facilities that use very old machines, as they won't be able to provide images that are up to par by today's standards," says Dr. Sewell. "If I'm referred a patient whose screening mammogram found something suspicious, but it was performed using a very old machine, I'll often re-image both breasts using our equipment, so I know that I can fully trust what I'm looking at. Not all equipment is created equally."

One of the ways that Houston Methodist Breast Care Centers lead medicine is by offering the newest, state-of-the-art technology and treatments, including molecular breast imaging, contrast-enhanced mammography, cryoablation of breast cancers and various non-wire localization devices to help surgeons find breast cancers in the operating room.

5. Has continuity of care

One of the most important parts of an annual mammogram is going to the same place every year, so your breast radiologist has the advantage of being able to view your prior images. This helps make even the slightest changes in breast tissue easier to notice.

Dr. Sewell says that most women don't remember to bring their prior images to a new facility, a failing that can hinder early detection of breast cancer.

"Breast tissue varies greatly and, like a fingerprint, everyone's breast tissue is unique," says Dr. Sewell. "Some breasts are dense, others are fatty. Some people have asymmetry, whether that's due to a previous surgery, breast implants or just because. All of these factors make it that much more difficult to identify a small change if we don't have prior images to compare the current ones with."

In short, once you find a breast imaging facility you like and trust, you should stick with it.

"If you switch facilities — when moving between cities, for instance — be sure to ask for all of your previous images and share those with your new breast care center," adds Dr. Sewell.

Lastly, to ensure the most seamless care possible, you might also consider choosing a breast imaging center that's part of a hospital offering other women's health services, including breast cancer treatment. Houston Methodist Breast Care Centers are an example of this.

That way, if a health issue is identified, you'll have access to the other sub-specialists and technology needed to receive the best care and treatment possible.