Have you recently celebrated your 40th birthday? Are you older than 40 but have been hesitant to schedule your first mammogram? Are you younger than 40 but considered to be at higher risk for developing breast cancer? No matter the reason we applaud you for taking this very important step in your breast health by scheduling your first screening mammogram. The thought of undergoing a mammogram is daunting for many women…so let’s talk through some common concerns to help make the process more understandable.
What should you do to prepare for your appointment?
- Do not wear deodorant, body powder, or glitter on the day of your appointment. If these are present on your skin during the exam it may interfere with the mammogram and lead to requests for additional imaging.
- It’s not the end of the world if you forget…. wipes will be provided at the time of your appointment to clean your skin.
- Wear shorts, pants, or a skirt to your appointment so that you can easily undress from the waist up. Dresses or other one-piece clothing should be avoided.
- Be prepared to answer questions that will be used to determine your lifetime risk of developing breast cancer. These questions may include:
- Age at first menstrual period
- Have you gone through menopause? Have you had a hysterectomy? If so, do you still have your ovaries? If you aren’t sure about the answers to these questions you may want to check with your primary care doctor or OB-GYN doctor ahead of time.
- Have you ever taken hormones? This includes birth control pills and hormone replacement therapy.
- Any family history of breast cancer? If so, at what age were they diagnosed?
- Any family history of ovarian cancer? If so, at what age were they diagnosed?
- Have you or any family members been tested for genetic mutations known to be associated with an increased risk of breast cancer?
- Any personal history of breast surgery? This includes breast implants, lifts, and reductions.
What should you expect during your appointment?
- If you did not complete the check-in process online prior to arriving for your appointment, you will be asked to check in which includes answering the questions discussed above when you arrive for your appointment.
- You will be escorted to the dressing room and asked to undress from the waist up. A gown will be provided for your comfort.
- A technologist will interview you and go over your answers to the questions outlined above.
- The technologist will inspect your breasts for any skin changes or puckering. They may also place markers on your skin showing where moles and/or surgical scars are located.
- The technologist will manually place your breast in the machine for each image to ensure proper positioning while also coaching you for body placement to ensure you are as comfortable as possible.
- There are 4 standard images that will be obtained: 2 of each breast. Additional images may be necessary in the event that the image quality was not optimal, if you have breast implants, if the entire breast cannot be seen on a single image, or for certain 3D machines.
- For each image the breast will be compressed for a short period of time in order to obtain the best possible image.
- Expect to spend 45 minutes to an hour at the facility to complete the entire process.
Why do we need to compress the breasts for the mammogram?
There is no way around it…. obtaining the best mammogram image does involve compressing the breast. Better compression=better images=better chance for the Radiologist to find a very subtle early cancer if it is present. Let’s be honest. No one is signing up for this exam because they want to have their breasts compressed. You are signing up for the exam so that if breast cancer is present, it can hopefully be found at a small and treatable size. Unfortunately, we must endure some breast compression to get the desired result: the best mammogram images possible to be able to detect cancer.
Will the mammogram hurt?
Truthfully? Possibly yes…people have varying degrees of discomfort and/or pain associated with their mammogram. Women describe their experience with mammogram compression anywhere from slight discomfort to pain. This is based on multiple factors. First, everyone experiences pain differently, so it is hard to predict each individual woman’s level of pain and/or discomfort. Additionally, some women tend to have more tender breasts. If you tend to have more sensitive/painful breasts, the mammogram might be more uncomfortable for you. If you fit in this category, try to schedule your mammogram for the week following your menstrual cycle. Hormone stimulation of the breast tissue is a very common cause of breast pain and discomfort. The week following your menstrual cycle is when the hormonal stimulation of the breast tissue is at its lowest point so the amount of discomfort you experience during the mammogram should be at its lowest point as well.
When the technologist places your breast in the machine, it requires you to turn your head to one side and retract your shoulder/raise your arm so that the breast tissue comes forward. If you have a history of neck or shoulder injury this may be uncomfortable. Let the technologist know ahead of time so they can work with you to obtain the best images with the least discomfort.
How will I get my results?
The facility that performed the mammogram will send you a letter with the results of your mammogram. If you are found to have dense breast tissue, this information will also be included in this letter. The radiologist generated report for the mammogram will also be available in the online patient portal.
What if the mammogram is abnormal?
It is common to be asked to return for additional imaging following your first mammogram– don’t panic! This is discussed in more depth here and here.
Often the unknown can be scarier than the known. We hope this article gives you more familiarity with the screening mammogram so that your first mammogram experience is not quite as scary. We applaud you for taking this first step in scheduling your mammogram– kudos to you for keeping on top of your breast health!