You've done it. You've scheduled a mammogram. Whether it's your first mammogram or you've been called back for extra views, you may have questions about how the appointment will go. Let's walk through what you can expect during a mammogram appointment.
Do I need to do any prep before a mammogram?
"Make sure that the skin is nice and clean," says Dr. Ainell Sewell, a breast radiologist with Houston Methodist. "Don't apply any kind of fragrance, lotions or creams. Some of those products have aluminum in them, which can show up on the mammogram. So just clean, dry skin and that's about it."
Dr. Sewell also says that if you experience breast sensitivity during your period, you may want to try to schedule your mammogram at a time you won't be menstruating. Or, if you happen to be on your period at the time of your mammogram, you can consider taking an aspirin or ibuprofen ahead of the appointment.
Is a mammogram painful?
The level of discomfort felt during a mammogram is unique to each person. Pain tolerance is a factor, as well as the potential timing of your menstrual cycle. Discomfort may be felt during the compression of a mammogram, but the potential discomfort serves a purpose.
"Compression in a mammogram is so incredibly important," Dr. Sewell says. "Number one, it produces a better exam. We need that compression in order to differentiate if something is there — is it a mass or is it just breast tissue? And what the machine does is spread out the tissue during that mammogram so that we can get a good look. Compression also decreases the amount of radiation exposure that the patient is going to have."
That said, Dr. Sewell shares that technologists are not out to inflict pain. If you're worried about pain, you'll want to talk to your technologist before you begin. They can work with you to make the process as comfortable as possible. You could also take a pain reliever ahead of your appointment if pain is a concern.
What to expect at a mammogram appointment …
In the waiting room
Mammogram appointments always begin the same way: You will check in and fill out any necessary questionnaires about your health history.
"It's just a series of questions," Dr. Sewell says. "'Have you ever had any kind of breast surgery? Was it breast augmentation or a reduction mammoplasty or any type of surgical procedure? Have you ever been diagnosed with breast cancer?' And there will be family history questions — 'Has your mother, father, brother or sister or your own child been diagnosed with breast cancer?'"
In the changing room
Once all necessary paperwork and questionnaires are addressed, a mammogram technologist will escort you to a changing room. At that time, you'll be given a robe and privacy to change into it — you'll only need to remove your top and bra. You'll be provided wipes to remove any deodorant or lotions. You'll also be able to secure your personal belongings into a locker or use the restroom if you need to. Once ready, you will be taken to a breast imaging room with the 3D X-ray machine.
For a screening mammogram
Once you're in the mammogram room, your technologist will ask you questions about your breasts and any changes or breast lumps. From there, you will be instructed to uncover one side of your chest. There, the technologist will help position you on the X-ray. They will tell you where to stand and how to position your head and arm. Before completing the image, the technologist may ask you to hold your breath and stay still. The machine will briefly compress your breast while the image is taken. This will be repeated to get the four standard images.
Once the technologist has completed all the views on one side, you'll be asked to cover up and to uncover the other side. You will then complete the process on the other side. At this time, if your appointment is a screening mammogram, you'll be taken back to the changing room because your appointment is complete. From there, you should get your results within 24 to 48 hours.
"Every screening mammogram is usually read same-day or next day," Dr. Sewell says.
For a diagnostic mammogram
A diagnostic mammogram appointment can vary depending on what was seen during your initial mammogram.
"Sometimes we do need ultrasound to kind of penetrate especially dense breast tissue to look at something and see if it is cystic or solid inside," Dr. Sewell said. "And so, sometimes we can go straight to ultrasound or in other circumstances we need further images to tell us what's going on. And then, in those circumstances, we are going to get a mammogram first and then possibly an ultrasound, or just the mammogram. Again, it all depends on what we're looking at."
If your breast radiologist ordered a diagnostic mammogram, your technologist will follow the same procedure as a screening mammogram. They'll ask you questions, and they will take the standard views on each side required for a screening mammogram.
From there, your tech will then begin to do spot compression or magnification images of any areas of concern found during your previous mammogram or during a clinical exam or self-exam. The tech will position you and your breast to get these specific views. The spot compression may be uncomfortable, but only lasts a few seconds. Once that's complete, your tech will take you to get a breast ultrasound if that's part of your appointment. If not, your breast radiologist or technician will talk with you immediately about your results and any next steps.
How long does a mammogram take?
In general, screening mammograms can take anywhere from 15 to 30 minutes and a diagnostic mammogram can take anywhere from 30 minutes to 1 1/2 hours. That's the total time, including the time it takes to check in, change into the robe, do the test(s) and change back into your clothes.
The actual imaging portion of a screening mammogram appointment can take as little as five minutes to complete. A diagnostic mammogram appointment will include extra images in addition to a screening mammogram and may also include a breast ultrasound. This can add time to the length of the appointment (closer to the 1 1/2-hour mark).
Mammography is the best tool to find breast cancer
Detecting breast cancer early is critical. The earlier it is found, the easier it is to treat — and a mammogram is the best tool to find it.
"We recommend that women who are asymptomatic and average risk start mammograms at the age of 40 every single year up until good health," Dr. Sewell says. "What does 'until good health' mean? I like to think of someone like Betty White, who lived to almost 100 and was living her best life in her golden years. It would be absolutely foolish to tell someone who is healthy to stop screening mammograms at 74, especially as the risk of cancer increases as we age. 'Until good health' is unique to the individual."
Women lead extremely busy lives — whether it is managing a career, family life, caring for elders or more. But scheduling and making time for your mammogram every year is one of the best ways to stay on top of your health.
"I always recommend that patients try to schedule their mammogram around a date that carries emotional weight," Dr. Sewell says. "The best way to remember that you are due for your mammogram is to associate the exam date with something that's important to you. It could be your birthday. It could be your anniversary. It could be when your children were born. That's a great way because when that day passes, and you're like, 'Wait a second, I didn't get it.'"
