Mammogram: What is it & how long do results take?

What is a mammogram?

A mammogram is a low-dose X-ray examination of the breast and breast tissue [1]. The main purpose of a mammogram is to help detect and diagnose breast-related medical issues like breast cancer, tumors, and cysts before symptoms appear. While discussion of these medical conditions can feel scary, early detection is very important because it can often lead to easier treatment. A mammogram might be recommended by a healthcare professional if you are already experiencing breast-related symptoms, but mammograms are also routine procedures for monitoring breast tissue health.

During a mammogram, the breasts are X-rayed by a special machine. A trained technician will place one breast at a time between two plates and compress, or flatten, the breast between the plates. This allows the machine to take a clear image of the breast tissue while exposing the patient to the lowest possible amount of radiation.

After the X-ray, the images are sent to a radiologist who examines them to check for any abnormalities. The radiologist will consult the patient’s previous mammograms if there are any, to look for changes in the breast tissue over time.

Depending on where you live, your mammogram might take place at a clinic, lab, hospital, mobile care van, private radiology office, or doctor’s office. 

At what age should you start getting a mammogram?

This depends a little on your medical history and where you live. Many countries advise women to begin having routine mammograms sometime between the ages of 40 and 55 until around age 75. In the U.S., the American College of Radiology (ACR), the Society of Breast Imaging (SBI), and the U.S. Preventive Services Task Force (USPSTF) recommend routine screening mammograms starting at age forty for all people assigned female at birth who have an average risk of developing breast cancer [2]. In the UK and Ireland, however, routine screenings begin from age 50. Be sure to check the medical guidance for your specific country to find out mammogram screening recommendations. 

Those with an increased risk of breast cancer due to personal history, family history, inherited genetic mutations, dense breasts, and certain noncancerous breast diseases can be advised to begin routine screening mammograms at an earlier age. Be sure to speak with your healthcare provider about your medical history for individual advice on when you should start having mammograms.

How regularly should you get a mammogram?

Those with an average breast cancer risk are advised to receive a screening mammogram around once a year [1]. Those with an increased risk might have mammograms more frequently. 

What to expect during a mammogram appointment?

Going for your first mammogram might feel daunting, and it’s OK to feel a little nervous. It’s important to remember that mammograms are routine procedures carried out by well-trained professionals. Knowing what to expect and preparing for your appointment can help you feel more reassured on the day of your exam. 

How to prepare

On the day of your mammogram, you can follow your normal routine including eating, drinking, and taking any medications [1]. However, it is recommended that you avoid wearing deodorant, perfume, lotion or body powder, as these can affect the accuracy of X-ray images. 

During a mammogram you will need to undress completely from the waist up, so it is recommended to wear a top and bottom rather than a dress or one-piece.

You might be asked to fill out a questionnaire about your medical history, current medications, any concerns or issues with your breasts, and your family’s medical history of breast or ovarian cancer.

If you are breastfeeding or pregnant, inform your healthcare provider. A breast ultrasound might be suggested instead of a mammogram.

If you have breast implants or have recently gotten a vaccine, inform your healthcare provider prior to your mammogram. Vaccinations can cause inflammation of the lymph nodes, which can show up on a mammogram X-ray.

Just before and during menstruation, the breasts can be more tender than usual. This can make a mammogram uncomfortable. For that reason, it is recommended not to schedule your mammogram the week before or during your period. Remember you can use the Natural Cycles app to track your menstruation cycle and make scheduling your mammogram easier.

During the procedure

Immediately before the X-ray, you will be asked to remove all clothing and jewelry from the waist up [1]. You might be given a medical gown or sheet to cover your upper body. The opening should be in the front. 

In some cases, the mammogram technician might place stickers on your nipples, birthmarks, or other skin markings to communicate these aspects of the image to the radiologist who will analyze the X-ray images.

Standing in front of the mammography machine, the technician will ask you to remove one breast from your gown. Then, the technician will help you position your breast on the machine’s imaging plate. The technician will then lower an upper plate so that your breast is placed firmly between the two parallel plates. 

The plates will be brought together to flatten your breast in order to take the X-ray image. This might be uncomfortable but should only last a few moments (usually 10 to 15 seconds). The process is repeated for a second view (side-to-side) of the same breast, and then the same images are taken for your other breast.

The technician might then leave the room to check the images. If there are any obscurities or if the images are unclear, they might need to be retaken. When a technician confirms all images are acceptable, the examination is complete. If you feel uncomfortable and want to take a break or stop at any time, you can let the technician or healthcare professional know. 

Who performs the procedure?

Mammograms are performed by specially trained technicians called radiographers, or radiologic technologists. After the procedure, a radiologist will view and interpret the images and send the results to your healthcare provider to share with you.

How long does it take?

How long the appointment takes can vary depending on a number of factors, including how busy the clinic is and the type of mammogram you are having. A regular screening mammogram can take up to twenty minutes [1]. In most cases, the X-ray part of the exam will only take a few minutes. Diagnostic mammograms can sometimes take longer if the radiologist needs detailed images of a particular area of the breast.

Is it painful? 

For most women, mammograms are not painful. Some women might feel pressure or discomfort during a mammogram due to the compression of the breast tissue between the imaging plates on the X-ray machine. The compression usually lasts about 10 to 15 seconds for each image taken [1]. The amount of discomfort can depend on the size of your breasts, where you are in your menstrual cycle, and your natural pain tolerance. 

Be sure to communicate to the technician if you are in pain at any point so they can help you adjust your positioning to be more comfortable.

A mammogram should not harm the breast or cause any long-term side effects to the breast tissue. If you continue to feel pain or discomfort after the procedure, talk to your doctor. 

Can I bring someone with me?

Yes, you can bring a partner, friend, or relative to your appointment. However, due to safety reasons, only you will be permitted into the X-ray room with the radiographer. Your companion can wait outside until the procedure is done. 

Screening mammogram vs diagnostic mammogram

There are two types of mammograms, screening and diagnostic [1]. A screening mammogram is a routine, preventative mammogram used to look for early signs of breast disease before a woman begins experiencing symptoms. A diagnostic mammogram is performed when symptoms like lumps, pain, or discharge appear, or there are changes in the breast skin or texture. 

The same machine is used for both types of mammograms, but a diagnostic mammogram might take more images and/or use more specific techniques to zoom in on the area with symptoms or abnormalities.

What’s the difference between a 2D and a 3D mammogram?

2D mammograms are more common. In a 2D mammogram, images of breast tissue are taken in 2-dimensions at a time: top and bottom and side-to-side  [1]. A 3D, or tomosynthesis, mammogram also uses two plates but takes images at multiple angles. Moving around the breast in an arc, the X-ray machine captures enough images to reconstruct a 3-dimension view of the breast tissue. 

Both types of mammograms can be used to detect breast tissue abnormalities. Studies have found that patients who have 3D mammograms experience lower rates of follow-up testing. 3D mammograms can also be useful for women who have denser breast tissue.

Are mammograms safe?

A mammogram is a low-risk medical procedure, and the benefits of this screening usually outweigh the risks. Depending on your medical history your doctor will be able to advise whether or not a mammogram is suitable for you. 

During a mammogram, the breast is exposed to a small amount of radiation. The amount of radiation is lower than in X-rays of lungs or bones. The average 2D mammogram exposes the breast to about 0.4 millisieverts (a mSv is a measure of radiation dose) [1]. To put this in perspective, the average person in the U.S. is exposed to around 3 mSv of radiation per year from their natural surroundings. The dose of radiation from a standard screening mammogram is about the same as what a woman would get from her natural surroundings in about 7 weeks. 3D mammograms can expose patients to slightly less, or slightly more, radiation depending on the type of machine used. It is advised to keep track of your past history of radiation exposure, like previous scans and x-rays, and inform your healthcare provider.

If you are pregnant, it is recommended to let your healthcare provider know. While mammograms are generally considered safe during pregnancy, screening mammograms are not usually performed on women who are pregnant and have no increased risk of breast cancer [1]. Your healthcare provider might decide to delay your mammogram until you are no longer pregnant or breastfeeding. Alternatively, your healthcare provider might recommend a breast ultrasound instead of a mammogram.

Can mammograms detect cancer?

Mammograms are primarily used to detect breast cancer by screening for changes and abnormalities in breast tissues. Screening mammograms cannot be used to diagnose, or confirm, breast cancer, but they can help medical care professionals determine if further tests like diagnostic mammograms, ultrasounds, MRIs, or biopsies are needed. 

The earliest forms, or stages, of breast cancer, can be highly treatable. Females are at a higher risk of breast cancer than males, with approximately 99% of cases occurring in women [3]. Breast cancer is the second most common cancer among women in the United States [4]. Mammograms are highly recommended because they help detect breast cancer before physically noticeable symptoms develop. 

The most common symptoms of breast cancer include palpable (detectable by touch) lumps, changes in breast size, shape, and appearance, abnormal or bloody nipple discharge, and changes to the nipple or surrounding skin (areola). Most symptoms are painless, but women who detect any symptoms should seek medical care. 

How long do mammogram results take?

Mammogram results can take anywhere from a few days to a few weeks. Depending on where you live and your healthcare provider, you might receive your results in the form of a letter, email, or call. If you do not hear back from your healthcare provider within the expected timeframe (figure around ten days [1], if you do not know), contact your healthcare provider. When scheduling your mammogram, you can ask your provider how long the results will take. This will help you better anticipate when you can expect results.

How accurate are the results?

Mammograms are 87% accurate at detecting breast cancer diagnosed within the next 12 months and are considered the best screening tool for early detection of breast cancer [5] .

Though uncommon, there are risks of false-positive or false-negative results from a mammogram [1]. These can contribute to psychological distress, anxiety, and delays in treatment. False-positive results are when radiologists detect abnormalities that require further testing, but determine that breast cancer is not present. In other words, false-positives are false alarms. False-negative results are when mammogram results appear normal, but breast cancer is present. False-negative results are more common amongst women with higher breast density, because it can be more difficult to detect tumors in the breast tissue. For this reason, it is always important to talk to your doctor if you notice changes in your breast appearance or texture, even if your recent mammogram was normal.

What does a normal mammogram result mean?

A normal mammogram result means that the breast tissue does not show any irregularities requiring further examination. A normal mammogram result means that you do not need any follow-up examinations and can wait until your next routine mammogram. However, if you notice new or different breast symptoms at any time, always consult your healthcare practitioner. 

What does an abnormal mammogram result mean? 

An abnormal result means that the radiologist saw something in the X-ray image that requires further examination. It is important to remember that an abnormal mammogram result does not mean you have breast cancer: less than 1 in 10 women with an abnormal mammogram result are diagnosed with cancer after further testing [6]. Amongst women receiving annual screening mammograms, around half will receive at least one false negative [1]. Still, it’s important to attend any follow-up appointments in order to investigate all potential abnormalities.

Abnormal test results can sometimes happen when X-ray images come back unclear, or do not show a complete picture of the breast tissue. It also might be necessary to examine a particular area of concern more closely. 

Different tests can be used to investigate potential irregularities in breast tissue. An abnormal mammogram result can require a follow-up diagnostic mammogram, ultrasound, MRI, or biopsy (where a small sample of tissue is taken from the breast for further analysis in a laboratory). 

It is more common to require additional testing after your first mammogram, since there are no previous images for radiologists to refer to. Women who have not yet gone through menopause are also more likely to require follow-up examinations [6].

Breast exams vs mammograms

Regular breast self-exams (BSE) and clinical breast exams (CBE) are physical examinations of the breast’s appearance. A BSE is performed by yourself, on yourself, while a CBE is performed by a healthcare professional. A self-exam is an important tool that can help you understand the normal look and feel of your breasts so that you can recognize any changes and inform your healthcare provider. Similarly, a healthcare professional uses a clinical exam to screen for breast changes and abnormalities.

Mammograms enable doctors to detect changes in the breast tissue before symptoms of breast disease are detectable by sight or touch. Early detection of certain health conditions like breast cancer can significantly improve treatment. Breast exams do not replace mammograms and vice-versa; both have their place when it comes to maintaining your health.

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