Exactly what to expect at a mammogram 

If you have your annual mammogram on your calendar, good for you. You’re taking advantage of one of the safest and most accurate breast cancer screenings available. The procedure is credited with decreasing breast cancer mortality in the United States by almost 40% since 1990, according to the American College of Radiology.  

Mammograms can find breast cancer early, when it’s easier to treat. That’s why most doctors advocate strongly for them. 

Whether it’s your first mammogram or your 20th, here’s what you should know.    

What is the best age to start getting mammograms? 

A mammogram is simply a breast x-ray image used for screening and diagnosis. The initial or “baseline” pictures serve as a reference point for future comparisons.  

Different organizations recommend slightly different timelines, so have a conversation with your doctor about the schedule that’s right for you, based on your health and family history. Here are the guidelines:  

• As of May 2023, new draft guidelines from the U.S. Preventive Services Task Force advise all women to get screening mammograms every two years, starting at age 40 (until age 74).  This recommendation is expected to become official in the near future. 
• The American Cancer Society (ACS) recommends an annual screening from age 45 to 54, with screenings every one or two years after that, for as long as a woman is in good health. Women ages 40 to 44 have the option to start screening annually.  

Women at high risk for breast cancer may need to start screening earlier than 40, says the ACS. For example, your doctor might recommend early screening if a first-degree relative (mother or sister) had breast cancer. Or if you have a clear genetic risk, especially BRCA1, BRCA2, or other mutations.  

Statistics show that one in eight American women develop breast cancer in their lifetime. “So it’s important that even women without a family history get a baseline mammogram at 40 to help quantify factors such as dense breasts,” says Kristin Zorn, M.D., a gynecologic oncologist in Little Rock, Arkansas. 

Have screening questions?

The free Blue KC Care Management app makes it easy to get your questions about cancer screening answered. Download it now and use the access code kclinksupport to connect.

Get the app

What to do before you schedule a mammogram  

There are several steps you can take to help the process go more smoothly:  

If you’re premenopausal, plan your appointment around your menstrual cycle. You may experience less discomfort and tenderness if you’re screened a week or so after your period.  

If this isn’t your first mammogram but you’re going to a new facility, arrange to have your prior mammograms sent in advance. You can also request and bring a CD of the images. Having your previous results gives the radiologist a basis for comparison.  

Understand the screening options. Today’s mammograms are done digitally. That means the image is stored as an electronic file on a computer, according to the National Cancer Institute. There are two options:   

• Standard (2D) mammograms. These create a two-dimensional image of the breast.   
• 3D mammograms. These combine multiple images from different angles to visualize the entire breast. Not all screening centers offer them.     

Many studies have shown that 3D mammograms reduce the need for follow-up imaging. They also appear to find more breast cancers, according to the ACS. A large study is underway to compare the outcomes of 2D versus 3D mammograms.  

What to do on the day of your mammogram  

Dress comfortably. You’ll need to undress from the waist up and put on a gown. So plan to wear a top with pants or a skirt. You’ll also have to remove any necklaces.  

Skip the deodorant and lotion. Skin creams, lotions, deodorant, or any other product on or near the chest area can interfere with the x-ray pictures. You’ll be asked to avoid them before your exam.    

“The small amount of aluminum in antiperspirants can make it hard to distinguish between breast calcifications that may be problematic and metallic particles in the deodorant,” says Dr. Zorn.  Creams and lotions can cause the same problem, as well as make the breasts slippery during the compression that a mammogram requires.  

Inform the technician. Let the provider know if you’ve noticed recent changes in either of your breasts, are at a high genetic risk of breast cancer, or if you’re breastfeeding, may be pregnant, or have breast implants.  
  
It’s important to mention skin abnormalities too. “Moles, growths, or scars can complicate reading the mammogram, so you’ll want to point them out for the technician to mark,” says Dr. Zorn. Otherwise, they could be labeled as suspicious.  

What happens during the screening itself  

The procedure takes less than half an hour. You’ll stand in front of a special x-ray machine. A technician will position your breast on the machine. Then a plastic plate is lowered to compress your breast, which evens out the thickness and allows for better visualization. The pressure also prevents motion that could blur the image.  
 
You’ll be asked to hold your breath and remain still for a few seconds while the image is processed. Most full tests involve several pictures taken from above and from the sides of both breasts.  

Then you’ll wait while the technician confirms that the pictures are clear. Occasionally, dense breast tissue “folds” on itself and creates an inexact image, requiring an additional picture. It’s not a cause for alarm.  

Keep in mind that your technician cannot give you the results of the test, according to the Centers for Disease Control and Prevention.  

After the exam  

Once the mammogram is over, you can head home or back to work. Here’s what you can expect next:  

Get the results. By law, all patients must receive written exam results within 30 days. Most patients hear from their doctor far earlier than that. If not, call and ask for the findings.  

Ask questions. If you have any concerns, raise them with your doctor. Also, make sure you’re informed about the basic characteristics of your breasts.   

The U.S Food and Drug Administration recently ruled that mammogram reports sent to patients should include information about breast density. The report should say “not dense” or “dense.” Women who have dense breasts have a higher risk of breast cancer, according to the ACS.  

Don’t panic if your results are unusual. Sometimes the results are inconclusive, and you’re asked to come back for more tests. It’s important to know that most breast changes found on a mammogram are not cancer. In some cases, the issue is related to the quality of the pictures themselves. And even when something is detected, it is far more likely to be a harmless cyst, dense breast tissue, or a benign calcium deposit than anything serious.  

Did you get the all-clear? Great news. It’s important to track your breast health at home too. Get to know how your breasts look and feel at different times of the month. Pay attention to any changes — and inform your doctor if something concerns you.   

Additional sources: 
Mammogram statistic: American College of Radiology 
Screening recommendations: U.S. Preventive Services Task Force; American Cancer Society 
Lifetime breast cancer risk statistic: American Cancer Society 
Screening options: National Cancer Institute 
Results: Centers for Disease Control and Prevention 
Breast density: American Cancer Society 
 

Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association. 

This information is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you read in this article. If you think you may have a medical emergency, call 911 or go to the nearest emergency room immediately. Neither Blue KC nor its employees, nor any contributor to this information, makes any representations, express or implied, with respect to the information provided herein or to its use.