5 questions to ask before a mammogram
We often think of breast cancer when we hear the “M” word. However, a mammogram is simply an X-ray of the breasts to help make sure your breasts are healthy. These X-rays may pick up signs of breast cancer or other breast conditions that can’t be seen or felt.1
You’ve likely read articles about mammograms or heard stories from friends or family who may have gotten them, and maybe now you’re ready to get one yourself. Read on to learn which questions to ask your doctor, how to help prepare for your visit and what to expect from your mammogram.
Have this convo with your doc — soonish
When it comes to preventive health, there may be no such thing as “too early”. Especially when we’re talking about spotting cancer. It’s not a fun topic to talk about, but your doctor can help make you feel comfortable and heard. Whether you’re ready to schedule your first mammogram or you’re still a few years away, here are 5 questions to start the conversation when you feel ready.
Once you turn 40 (cue the funny-but-a-little-hurtful cards about getting old), you might choose to get yearly screening mammograms up until you’re 44. The American Cancer Society’s guidelines recommend women 45 to 54 get their yearly mammograms, no question. Once you hit 55 (and you’ve had a clean bill of breast health), you might switch to getting one every other year.2
If you’re at greater risk for developing breast cancer, you may need to start earlier than 40. Be sure to tell your doctor if you have any of these risk factors:3
- Personal history of breast cancer or noncancerous breast conditions (you may need to get diagnostic mammograms instead of screening mammograms)
- Family history of breast or ovarian cancer
- Previous radiation treatment on your chest
- History of taking hormone medicines (like birth control or hormone replacement therapy)
- Having dense breasts
Every woman’s journey with her breast health is different. Be sure to have an open, honest conversation with your doctor about your health history, risk factors and any personal concerns.
With any kind of screening or treatment, it’s important to weigh the pros and cons. Mammograms may not be different. Some may worry about radiation exposure, but mammograms only involve a tiny amount of radiation, even less than an X-ray. The dose is low enough that the benefits of regular screenings may outweigh any potential radiation-related issues. Of course, talk with your doctor if you have concerns.4
Valid question. You want to make sure these mammograms you’re getting are actually doing their job. Right now, the CDC says that mammograms are the best kind of screening we’ve got — but they’re not perfect. 5 It’s good to know what limitations exist, so you can ask the right questions along your health journey. Things like, “Could this be a false-positive?” Or, “Is that treatment really necessary?"6
- False-negative results: For example, cancerous tissue could be mistaken for normal dense breast tissue. Unfortunately, screening mammograms miss about 1 in 5 cancers.7
- False-positive results: Thinking you have cancer (when you don’t) can cause anxiety and may often lead to additional testing that isn’t needed.
- Overdiagnosis or overtreatment: Mammograms help spot cancer, whether it’s a type that warrants treatment or not. (There are actually some cancers that don’t pose a threat — who knew?) The problem is doctors may not always tell which cancers might become life-threatening, so the safest bet may be to treat whichever cancer is found. An overtreatment of cancer may expose you to treatment side effects when it’s found by medical professionals to not be needed.
Remember, this is your body. Ask all the questions you want. Plus, you may look like a whiz in front of your doctor.
Well, it may not the most pleasant test in the world. But there may be comfort in knowing you’re braving discomfort for the good of your overall health. During the screening, your breasts take turns resting on a platform and having gentle pressure applied. It only lasts a few seconds so the X-ray machine can spread out your breast tissue to snap the best shot. Plus, this pressure actually helps minimize the dose of radiation needed. The flatter the pancake, the less time it needs to cook. You know? So, you may have some discomfort. If you’re in a lot of pain, kindly ask the technician to ease up a bit.8
Depending on your personal health and health history, your doctor may recommend the mammogram that’s right for you.9,10
- Screening mammogram: This is your standard go-to if you’re at average risk for breast cancer with no obvious signs or symptoms of a breast condition. If you schedule routine mammograms as preventive screenings, this may be the type of mammogram you’ll have.
- Diagnostic mammogram: If you’ve had an abnormal screening mammogram or have signs of a possible breast condition (like a lump, pain, discharge, thickening breast skin, or changes in breast shape or size) you may get a diagnostic mammogram. Your doctor might also order this for any special circumstance, like if you have breast implants. Many implants make it more challenging to see every part of breast tissue, so more images may be needed to get the full picture. This kind of mammogram may provide a more detailed X-ray than a screening mammogram and may take a little longer, so be sure to plan accordingly.
- 3-D mammogram: This is an option that may provide a clearer image of breast tissue compared to a standard 2-D screening mammogram. (You can put your little red and blue 3-D glasses away, it’s not that kind of 3-D.) This type of mammogram combines multiple X-rays to create a three-dimensional picture of your breasts.
This may be the best option if you have dense breasts because both dense tissue and cancer tissue show up white on a standard mammogram So, it might be hard to tell the difference between normal breast tissue and abnormal (possibly cancerous) tissue. This is why that false-negative could happen. A 3-D image can let doctors see more than just density, which may lead to a more accurate diagnosis. Like a diagnostic mammogram, this type of mammogram might also be a good option if you have breast implants.
All that said, there’s no right or wrong mammogram. Talk with your doctor about which one may be the best for you to get.
Preparing for your mammogram
There are a few things to keep in mind as you schedule and go to your mammogram appointment. First, be sure to choose a certified mammogram facility. If it’s certified by the FDA, you’re good to go. This just means you can count on that facility to meet certain standards.11
Here’s a quick checklist for the day of, no matter which kind of mammogram you’re headed to.12,13
- Firm breasts — check! Your appointment should be on a day when your breasts are least likely to be tender. That’s usually the week after your period or any time after menopause.
- Any prior mammogram images. If you’re visiting a new clinic, ask your previous clinic to send over records of your past mammogram images so the radiologist can compare them against your new ones.
- Don’t shower or wear deodorant. We know, we know. Not ideal. But we’re just lookin’ out for you. Metallic particles in any kind of antiperspirant, soaps or lotions might show up on your X-ray and cause confusion. Maybe shoot for an early morning appointment so you can head home and shower right after you’re done.
- Talk TMI. Tell your technician anything you think is important. Things like whether you’re pregnant (or think you might be) or have breast implants. Better yet, mention it when you call to schedule your appointment.
Where can I get a mammogram?
Did you know you don’t need a referral or doctor’s note to schedule a mammogram? That’s right, once you turn 40 you can find yourself a mammogram facility and book a date for an X-ray. Even better? Most insurance covers your preventive screening mammograms starting at age 40. That doesn’t include 3-D or diagnostic mammograms. You’ll likely need to pay a copay or coinsurance, depending on your health plan. Sign into your health plan account to check your benefits and learn about your plan coverage for this type of screening.
- What is a Mammogram? cancer.gov, 2016.
- American Cancer Society Guidelines for the Early Detection of Cancer cancer.org, 2020.
- What Are the Risk Factors for Breast Cancer? cdc.gov, 2020.
- Mammogram mayoclinic.org, 2019.
- What Is Breast Cancer Screening? cdc.gov, 2020.
- Limitations of Mammograms cancer.org, 2019.
- False-negative results cancer.org, 2019.
- Mammogram mayoclinic.org, 2019.
- Diagnostic Mammogram nationalbreastcancer.org, 2020.
- 3D mammogram mayoclinic.org, 2020.
- Mammogram mayoclinic.org, 2019.
- Breast Cancer and Mammograms webmd.com, 2020.
- Tips for Getting a Mammogram cancer.org, 2019.