Mammogram

What is a mammogram?

A mammogram is a low-dose X-ray of your breast tissue. Healthcare providers use mammograms, or mammography, to look for early signs of breast cancer before symptoms develop. This is called a screening mammogram. Providers also use mammography to look for any abnormalities if you develop a new symptom, such as a lump, pain, nipple discharge or breast skin changes. This is called a diagnostic mammogram.

Aside from skin cancer, breast cancer is the most common cancer that affects people assigned female at birth (AFAB) and represents 15% of all new cancer diagnoses in the United States. An early diagnosis plays a big role in your breast cancer survival rate. Routine mammograms are key to catching breast cancer early. When breast cancer is detected early, the five-year survival rate is 99%. Mammograms are the gold standard in detecting breast tissue changes before they turn into cancer.

What are the different types of mammograms?

There are two main types of mammograms:

• Digital mammography in 2D.
• Digital mammography in 3D (digital breast tomosynthesis).

2D mammograms

2D mammography involves taking pictures of each breast at two different angles — typically from top to bottom and side to side.

3D mammograms

3D mammography is a newer type of mammogram in which each breast is compressed once and a machine takes several X-rays as it moves in an arc over your breast. A computer then puts the images together in “slices,” which allows healthcare providers to see your breast tissues in 3D.

Can a mammogram detect cancer?

Mammograms can help detect cancer, but they can’t diagnose cancer.

While mammograms can show abnormal breast tissue, they can’t prove that an abnormal area in your breast is cancer. Rather, mammograms are an essential tool for helping healthcare providers decide whether you need additional testing, such as a breast biopsy. A breast biopsy can determine if tissue is cancerous or noncancerous.

At what age do you get a mammogram?

The U.S. Preventive Services Task Force recommends that all people AFAB receive mammograms every two years beginning at age 40 until they reach age 75. Other medical groups have different recommendations. Talk with your healthcare provider about what recommendation is right for you.

If you have a higher risk of developing breast cancer, you may need to have screening mammograms before age 40, or more frequently. Your provider may also recommend supplemental screening with other tests, such as a whole breast ultrasound or breast MRI (magnetic resonance imaging).

Your healthcare provider can perform a breast cancer risk assessment to determine if you’re at a higher risk. If you have any of the following risk factors, talk to your provider about when you should start getting annual screening mammograms:

• Personal history of breast cancer.
• Family history of breast or ovarian cancer.
• Inherited genetic mutations, such as BRCA1 and BRCA2.
• Certain benign (noncancerous) breast diseases such as atypical ductal hyperplasia.
• Dense breasts.

Occasionally, people assigned male at birth (AMAB) may also have a high-risk level because of their family history and may also have screening mammography. In general, though, about 1 out of 100 breast cancers occur in people AMAB.

How often should you have a mammogram?

How often you need to get a mammogram depends on your risk. If you have an average risk of developing breast cancer, you should get a mammogram every one to two years beginning at age 40. If your risk is higher, you may begin mammograms sooner or need them more often. Talk to your healthcare provider about your mammography schedule, which is based on your medical history and other factors.

How does a mammogram work?

A mammogram uses an X-ray machine that’s made specifically for breast tissue. The machine takes X-rays at lower radiation doses than the X-rays that look at your bones.

During a mammogram, you place your breast on a support plate attached to the X-ray machine. A technologist then squeezes your breast with a parallel plate called a paddle. The machine produces X-rays that pass through your breast to a detector located on the opposite side. The detector transmits electronic signals to a computer to form a digital image. These images are called mammograms.

Breast compression is necessary for a mammogram to hold your breast still and minimize movement, which can cause the X-rays to look blurry. Compression also evens out the shape of your breast so that the X-rays can travel through a shorter path to reach the detector. This allows for a lower radiation dose and improves the quality of the image.

Who performs a mammogram?

A healthcare provider called a radiology technologist or a mammographer performs a mammogram. They have special training in performing a mammogram safely and properly. A board-certified physician radiologist who’s specially qualified to interpret mammograms then views and analyzes the mammogram images. They send the results to your healthcare provider, who will then share them with you.

How do I prepare for a mammogram?

There are a few things to do or keep in mind when scheduling your mammogram, including:

• If you’re breastfeeding, pregnant or think you may be pregnant, tell your healthcare provider. They may recommend the best time to get a mammogram or suggest starting with an ultrasound. If you still get a menstrual period, try not to schedule your mammogram the week before you get your period or during your period. Your breasts may be tender during this time, which could make the procedure more uncomfortable.
• If you have breast implants or recently got a vaccine, be sure to tell the scheduler.

On the day of your mammogram, follow these guidelines:

• Follow your normal routine — eat, drink and take your normal medications.
• Don’t wear deodorant, perfume, lotion or body powder. These products can interfere with the accuracy of the X-ray images.
• You’ll need to undress from your waist up for the imaging procedure. You’ll have a medical gown or drape to wear.

What should I expect during a mammogram?

A mammogram involves the following steps:

1. You’ll need to remove all clothing and jewelry above your waist. A provider will give you an open-front hospital gown or drape to wear.
2. You’ll stand in front of the mammography machine, and the technologist will ask you to remove one breast at a time from your gown. You’ll position your breast on a breast support plate.
3. The technologist will lower a plastic paddle to compress your breast against the support plate. You may feel some discomfort or pressure during the period of compression. If you’re unable to tolerate the pressure, let the technologist know and they’ll adjust accordingly.
4. The machine will take images of your breast while it’s compressed.
5. If you have two breasts, you’ll repeat this process for your other breast.
6. Once the technologist is done taking images with the machine, the procedure will be over. You’ll put your clothes back on and you can leave the facility.

Most people will be able to resume their normal activities immediately after their mammograms.

Do mammograms hurt?

Having a mammogram feels uncomfortable for some people due to the pressure on your breast tissue from the compression. For some, it’s painful. The good news is that a mammogram is a brief procedure, and the discomfort doesn’t last long. If you feel intense pain, tell the technologist immediately.

The level of discomfort you may feel depends on a few factors, including:

• The size and density of your breasts.
• How much your breasts need to be compressed.
• If you’re about to get or are on your period.
• The skill of the radiology technologist.
• Your ability to relax and position yourself in the best way for good images.

How long does a mammogram take?

Screening mammograms usually take about 15 to 20 minutes. Diagnostic mammograms may take longer due to your provider needing to take extra images.

Are mammograms safe?

Mammograms expose your breasts to small amounts of radiation, but the benefits of mammography outweigh any possible harm from the radiation exposure.

If there’s any chance you might be pregnant, let your healthcare provider and technologist know. Although mammograms are safe during pregnancy, healthcare providers may recommend postponing screening mammograms if you don’t have an increased risk of developing breast cancer and are pregnant.

How long does it take to get mammogram results?

You’ll likely get your mammogram results within a few days, although this can vary. Often, radiologists compare your most recent mammogram to your last mammogram. Once they review your mammogram, they send the results to you and your healthcare provider.

Contact your provider or the facility where you got your mammogram if you don’t receive your results within a month.

What type of results do you get from a screening mammogram?

You’ll receive a result letter that gives basic information about the result and should be easy to understand. The letter may inform you of normal results or the need to return for additional imaging. Your mammogram report will also include information about your breast density, which is how much fibrous and glandular tissue you have in your breasts as compared to fatty tissue. This information is now mandated by law to be provided in your report. If you have any questions about your results, don’t be afraid to ask your healthcare provider.

Breast Imaging Reporting and Data System (BI-RADS)

Radiologists and healthcare providers use a standard system in medical reporting to describe screening and diagnostic mammogram findings called the Breast Imaging Reporting and Data System (BI-RADS). This system sorts the results into categories numbered 0 through 6. The system gives you your category, the finding and the explanation (including your risk for cancer).

What does a normal mammogram mean?

If you have a normal mammogram, it means that the radiologist didn’t find any issues or abnormal areas in your breasts in the images. If you have a normal mammogram, it’s important to continue to get mammograms at the interval your healthcare provider recommends. Screening mammograms are most helpful when a radiologist can compare them to ones you’ve had in the past to look for changes in your breasts.

What does an abnormal mammogram mean?

If a mammogram shows one or more suspicious regions, the radiologist will likely recommend additional specialized mammogram images — or other imaging tests such as a breast ultrasound or a breast biopsy.

Your healthcare provider will go over the next steps with you if you receive an abnormal mammogram report.

How accurate is mammography?

Mammography is 85% to 90% accurate. Mammograms have improved the ability to detect breast abnormalities before you can see them or feel them. But it’s still possible that an abnormality doesn’t show up on a mammogram.

It’s important to contact your healthcare provider right away if you feel something suspicious when self-examining your breasts or if you have any new breast symptoms.

Do breast implants interfere with mammograms?

Having silicone or saline breast implants and resulting scar tissue makes it more difficult for radiologists to see all of your breast tissue and possible issues on regular mammograms.

To help the radiologist see as much breast tissue as possible, people with implants usually have two extra pictures done on each breast, in addition to the four standard pictures taken during a screening mammogram. These extra images are called implant displacement (ID) views.

For ID views, the technologist gently pushes your breast implant back against your chest wall, pulls your breast forward over it and then compresses your breast. This allows for better imaging of the front part of each breast.

It’s important to let the mammogram facility know if you have breast implants when scheduling your mammogram and to let your technologist know on the day of your mammogram.