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Preparing for a Screening Mammogram: Your Ultimate Guide

Key takeaways:

  • Women over the age of 40 should get a screening mammogram every year according to the American Cancer Society.
  • A self-exam can help you decide whether to schedule a screening mammogram.
  • However, a screening mammogram is an early detection tool for breast cancer in and of itself, without the need for a self-exam.
  • Before your screening mammogram, avoid wearing scents and come prepared with any prior mammogram records you have.
  • If breast cancer is seen in the images, you might have to schedule a diagnostic mammogram.
  • If you have dense breast tissue, you might have to schedule a breast MRI scan

Screening mammograms can prevent serious illness and save your life by finding breast cancer as early as possible.

Early detection also means fewer women face mastectomies because, when detected early, breast cancers can be treated without full breast removal.

Women are advised to have their first screening mammogram at age 40, and they should schedule regular mammograms each year thereafter.

For at-risk women with a high family history of breast cancer, an annual mammogram regimen for breast cancer screening should begin at age 30.

Other risk factors for breast cancer include age, history of cancer or other breast issues, obesity, excessive alcohol consumption, early onset of menses, post-menopausal hormone therapy, and radiation exposure.

The purpose of a screening mammogram.

Screening mammography can detect breast cancer when there are no overt signs. Your first mammogram is a baseline that reveals the characteristics of your breast tissue, which can sometimes be dense or fibrous.

Women with dense breast tissue or at very high risk of breast cancer should also consider getting a breast MRI scan.

Your doctor will usually compare subsequent mammograms to your baseline.

Very often, breast cancer is detected early because of a screening mammogram.

Screening mammograms vs. diagnostic mammograms

Both mammograms expose breast tissue to high-resolution X-ray images and low-dose radiation to capture pictures of your breast tissue.

These types are: standard 2-dimensional digital mammography or 3-D mammograms called tomosynthesis.

A diagnostic mammogram checks irregularities in a screening mammogram. It involves more images and often focuses on the tissue area of concern. Diagnostic mammograms can show tumors that are possibly too small to be felt in a breast exam.

Diagnostic mammography may also catch ductal carcinoma in situ (DCIS) — these are abnormal cells in the breast duct’s lining.

If there are irregularities in a screening mammogram, your doctor may order a diagnostic mammogram, an ultrasound, and/or a breast MRI scan.

A diagnostic mammogram checks irregularities in a screening mammogram. It involves more images and often focuses on the area of concern.

A self-exam can help decide whether to schedule a screening mammogram.

Screening mammogram: A woman self examining her breast

Women should do monthly breast self-examinations 3 to 5 days after their period begins. This is the most optimal time for a BSE because your breasts are less likely to be tender or swollen.

Post-menopausal women should do their breast self-exam on the same day every month, which also makes it easier to remember.

Doing a self-breast exam is easy and fast and can lead to early, life-saving detection of breast cancer. The National Breast Cancer Foundation has a good resource for learning how to do a breast self-exam at home. 

  • While standing, check your breasts and armpits for lumps, ridges, thick-feeling tissue, or discomfort with the pads of your middle fingers.
  • Use light, medium, and firm pressure to palpate each breast in a circular motion.
  • Finally, check each breast again while lying on your back with the opposite arm raised over your head.

If you find any abnormalities when doing your self-exam, you should schedule a screening mammogram right away.

Instead of doing a self-exam, you can also contact your health care provider to schedule a clinical breast exam.

What’s the difference between a breast self-exam and a clinical breast exam?

Your doctor or nurse practitioner will do a clinical breast exam to evaluate the skin and tissues of your breasts. Usually, your family GP or your gynecologist will perform the exam in their office.

Breast self-exam procedures are essentially the same as a clinical exam — you should examine your own breasts every month.

The advantage of having a clinical exam is that your doctor may find abnormalities in your breast that you did not detect.

A clinical exam should be conducted once a year during your regularly scheduled gynecological checkup.

How to prepare for your screening mammogram and what to expect.

For your mammogram appointment, do not use deodorant, powder, or lotions, as they can interfere with imaging. The mammography technician will give you a hospital gown and ask you to undress to the waist.

The technician will also ask questions about your medical history, lifestyle, mammography history, and findings, as well as any current issues you may have. This is the time to tell your radiology technician if you have dense breast tissue, breast pain, or other problems with your breasts.

Other best practices for scheduling regular screening mammograms include:

  • Use a facility that specializes in mammograms, ultrasounds, or MRI scans.
  • If possible, go to the same facility every time so they have your records on file and know your baseline.
  • If you move, arrange to have records transferred to a new facility.
  • Schedule your mammogram for the week after your period starts.

What to expect after your regular screening mammogram.

You and your doctor will get a report from the radiologist. The radiologist may categorize your results using a numbered system called BI-RADS (Breast Imaging Reporting and Data System) that classifies findings on a scale of 0-6 with a score of six being most severe.

If your mammogram does show an abnormality, you’ll need follow-up, which likely entails a diagnostic mammogram or a breast ultrasound, and in some cases, a breast MRI could be recommended.

Most abnormal findings on a mammogram are not breast cancer. Abnormal mammogram findings are often indicative of dense breast tissue, benign cysts, or calcium deposits.

When you need a diagnostic mammogram.

Screening mammogram: Doctor explaining mammogram results to a patient

The technologist reading your mammogram will look for different types of breast changes.

  • Calcium deposits in the breast tissue are called calcification. Macrocalcifications are large and usually due to aging, injuries, or inflammation. Microcalcifications are minuscule dots that may or may not have a suspicious look and pattern.
  • Masses are dense breast tissue with a suspicious shape and edges. They may be cysts, fibroadenomas (solid non-cancerous solid tumors), or cancerous tumors.
  • Breast density is determined by fibrous and glandular tissues distributed in your breast, compared to fatty tissue. Dense breasts are not abnormal, but according to studies, they are linked to a higher risk of breast cancer. Dense breasts can obscure signs of breast cancer on a mammogram, which is why a breast MRI is recommended for women with dense breast tissue.

According to the Centers for Disease Control and Prevention, self-exam warning signs of breast cancer range from lumps felt in the breast tissue or armpits to nipple discharge, pain, swelling, or even visible signs of redness or irritated skin.

Your doctor will refer you for a diagnostic mammogram if there are questions about your clinical breast exam or screening mammogram. A diagnostic mammogram can provide more information.

Your doctor might order an ultrasound test and possibly a breast MRI (magnetic resonance imaging).

Your doctor will only be able to determine if you need a biopsy upon completion of your screening tests.

Sometimes, the image just isn’t clear. Breast density is an issue, or there may be a cyst, solid mass, or calcifications. If the imaging shows suspicious abnormalities or lumps, your doctor may order a biopsy.

Fewer than one in 10 women are called back for more tests turn out to have cancer.

What is a breast ultrasound, and why would one be indicated?

If your physician wants more data, they may order a breast ultrasound alongside your screening mammogram.

Ultrasound produces a sonogram by using penetrating sound waves that do not affect your tissues. Your breast tissue deflects the waves, causing echoes. A computer uses those echoes to create a picture of the breast.

A sonogram can show whether an abnormality such as a lump is a solid mass, a fluid-filled cyst, or a combination. A diagnostic ultrasound can measure the size and location of the anomaly, and it can examine the surrounding tissue more closely.

Preparing for diagnostic mammography. 

Preparation for a diagnostic mammogram is much the same as preparing for a screening mammogram.

  • Let the mammography service provider know if you have breast implants.
  • Do not wear deodorant, perfume, talcum powder, or lotions.
  • Plan your appointment for a week after the start of your period.
  • Arrange to have records of your prior mammograms delivered for comparison.

Here’s what to expect during the diagnostic mammogram procedure.A nurse assisting a patient having a mammogram exam

A specially-trained radiographer will conduct the mammogram and breast compression. The squeeze on your breasts may be a little painful, but it’s necessary to create clear images. Compaction also reduces the amount of radiation required.

How reliable are screening mammograms?

Mammography is one of the most optimal tools for detecting breast cancer, especially for peri or post-menopausal women.

According to UC Health Today, a breast cancer diagnosis has an accuracy rate of approximately 78% through mammography, and the average risk goes up to about 83% in women over 50.

About 6-8% of the time, mammograms produce false positives. Likewise, false negatives are the result an estimated 17% of the time. The false-negative incidence increases to 30% in women age 50 and older.

Early discovery is the greatest defense against breast cancer. Mammography can identify suspicious breast tissue and provide essential health information before you, or your doctor can feel most tumors.

Though self-exam and screening mammograms can’t prevent breast cancer, they can help you detect breast cancer early, and potentially save your life.

More than a third of women who are eligible for a screening breast mammogram don’t book them. Our research shows that’s because booking mammograms just isn’t convenient. That’s why we’ve launched the Ezra Mammogram. Now available at our New York partner facilities (and soon available at our California locations), our service conveniently allows you to book your appointment online. Our mammograms are insurance-covered for women aged 40 or over (who have insurance), or $325 for self-pay. Plus, your 3D mammogram will take only 20 minutes, and your results will be available in just 48 hours. Book your mammogram today.