Frequently Asked Questions: Mammograms

Breast cancer is the most common cancer in women. Since 1 in 8 women develops breast cancer in her lifetime, screening mammograms are used to detect breast cancer before it spreads and when it is small and treatable. They also decrease the number of deaths from breast cancer.

These frequently asked questions address everything you need to know about mammograms: what they are, when to get one, the risk factors that make you more likely to need one, how to schedule one and the next steps to detect an abnormality.

What is a mammogram?

A mammogram is an image of the breast, obtained with a low dose X-ray. A radiologist looks for breast cancer on a mammogram. Breast cancer can often be seen on mammogram many years before the cancer becomes palpable. Breast cancer is more treatable when tumors are small and have not spread to areas outside of the breast. Mammograms play a crucial role in early detection of breast cancer and should not be skipped.

How is a mammogram performed?

A mammogram is performed by compressing breasts between 2 firm surfaces to spread the breast tissue evenly for a better, high-quality image. A radiologist then reads the image. They evaluate the image to see if anything has changed from previous mammograms or if there are any new abnormalities.

How long does a mammogram take?

Mammograms take about 15 - 30 minutes from start to finish; however, the actual process of getting the images is quick. The wait time varies and depends on factors, such as time spent:

• In the waiting room
• Filling out paperwork
• Removing and putting on clothes.
• Imaging
• Whether or not any images need to be taken

How do I prepare for a mammogram?

If you’re wondering how to prepare for a mammogram, there is not a lot to do. However, there are some important considerations.

• If you are pregnant or think you could be, you should first talk to your doctor. Routine screening mammograms should be postponed until after childbirth. However, if you are getting a diagnostic mammogram, the amount of radiation is safe during pregnancy.
• If you are breastfeeding, the milk ducts can increase tissue density, making it more difficult to detect abnormalities on mammograms. However, mammograms are safe when you are breastfeeding. If you are above the age of 40 and have not had a screening mammogram in over a year, or if you are high risk, discuss with your doctor as a screening mammogram may be recommended.
• Wear a shirt with shorts, pants or a skirt to undress from the waist up.
• Do not wear any deodorant, body powder, cream or lotion under your arms or breasts and avoid wearing jewelry on the day of your mammogram.
• If you have had mammograms elsewhere, send the mammograms to the radiologist so the current images can be compared.
• Eat, drink and take your medications so that you are hydrated. You don’t need to fast.

Do mammograms hurt?

A technologist will talk you through the entire exam and will position you for all images. The breast will be held in brief compression while each image is being taken. The compression should be firm, and may be slightly uncomfortable, but should not be painful. Communicate with your technologist during the exam if something is bothering you or if you have neck, shoulder or back problems that make the exam more difficult.

At what age should you get a mammogram?

Average risk women should begin annual screening mammography at age 40. Some women may need to start earlier or undergo more frequent screening if they have the following risk factors:

• A personal history of breast cancer or breast biopsy showing atypia
• A family history of breast cancer
• Genetic mutations such as BRCA1 or BRCA2
• Radiation to the chest in childhood
• Breast cancer syndromes, such as Lynch syndrome

When should I get a mammogram?

While a routine annual screening is important for those who are 40 years old and above or who have other risk factors, other circumstances may warrant breast imaging, such as:

• A lump or swelling in your breast, collarbone or underarm
• Any changes in the way your breast looks and feels
• Pain or tenderness in your breast
• A flat or indented area on your breast
• Nipple retraction
• Skin dimpling that looks like an orange peel
• Nipple discharge

Dense breast tissue is common and is not abnormal. Nearly half of women who undergo screening mammography have dense breast tissue. Breast density refers to the overall amount of breast tissue relative to fatty tissue in the breast. Breast density is a mammographic finding determined by a radiologist.

There are 2 significant problems with breast density:

1. Women with dense breast tissue have a higher risk of breast cancer.
2. Breast cancer is also more difficult to detect on a mammogram if a woman has dense breast tissue.

Women with dense breast tissue may benefit from additional, supplemental screening exams such as screening breast ultrasound or breast MRI.

Should you get mammograms with breast implants?

Yes, women with implants can and should continue to have annual screening mammograms. The technologist will obtain 2 extra images of each breast to ensure the breast tissue is compressed. In the images, the technician will examine the tissue surrounding your breast implants.

How often should you get a mammogram?

The American College of Radiology, Society of Breast Imaging, American Medical Association, American Society of Breast Surgeons and the National Comprehensive Cancer Network all agree that women should get a mammogram annually and begin screening mammograms at 40 years old.

Once you get your first mammogram, you should receive one every single year. If you are still unsure, discuss how often you should get a mammogram with your healthcare provider. They will provide you with an order for the imaging.

What is a 3D mammogram?

A 3D mammogram is the most advanced technology available for mammogram screening. It provides the radiologist with more images of each breast and gives a thorough evaluation of the breast tissue. Radiologists can evaluate the separate layers and tiny details to look for cancer more easily.

What is the difference between a 2D mammogram and a 3D mammogram?

The machine for the 3D mammogram is the same machine that is typically used for the 2D procedure. Your breast will be compressed as usual, and the process to prepare and experience is the same as a traditional mammogram.

2D mammograms

• Take a photo of each breast from the front and side to create a single image.
• Show areas of overlapping breast tissue on the image.
• May take a few seconds less than a 3D mammogram.

3D mammograms

• The X-ray tube moves in an arc around the breast during the scan to take many pictures from different angles to show each breast tissue layer.
• The computer creates a clear 3D image of each breast.
• 3D mammograms are less likely to give a false-positive result and decrease the need for follow-up images.

How can I schedule a mammogram?

If you’re wondering when and where to get a mammogram, you should always choose an accredited facility by the American College of Radiology. In fact, 3D mammograms are covered by Kansas and Missouri health insurance plans. However, the appointment must be 1 year and 1 day from your last mammogram.

We offer convenient online mammogram scheduling.

How much is a mammogram?

If you are wondering how much a mammogram costs, it depends on whether you have health insurance. If you have health insurance, it may be no cost or you may pay a deductible. However, if you do not have insurance, the typical out-of-pocket cost varies based on the facility and where you live.

How long does it take to get mammogram results?

The amount of time to get the mammogram results varies, whether it was a screening or diagnostic mammogram.

• Screening mammograms can be read by the radiologist on the same day. However, if you have received comparison images from an outside facility, it can take longer to receive the final report. You could receive your results by mail or phone.
• For diagnostic mammograms, the radiologist will usually give the results after all images are completed. This way, if any further imaging is needed, it can be done in the same appointment. 

What does a follow-up mammogram mean?

A follow-up mammogram is needed when the radiologist needs additional images to evaluate tissue that was not included on the screening mammogram, or to evaluate a possible abnormality. This second mammogram is called a diagnostic mammogram. According to the American Cancer Society, nearly 10% of all women who have a mammogram will need further testing.

More pictures are taken during a diagnostic mammogram to evaluate any areas of concern. An ultrasound may be needed following the mammogram. It helps the team look more closely at a mammogram. Most of the time, a diagnostic mammogram and ultrasound are normal or show a benign finding in the breast.

What are the results of a diagnostic imaging?

Following a diagnostic mammogram or ultrasound, you will likely hear one of the following:

• There is nothing to worry about, and you can return to the regular mammogram schedule.
• Repeat imaging in about 6 months.
• Biopsy of the breast tissue to evaluate for cancer.  

What percentage of diagnostic mammograms are cancer?

If you are in the 10% called back for a follow-up mammogram, know that you are not alone. About 90% of those women who underwent the follow-up tests are given the “all-clear” after completion. However, of the 10% who need additional testing, about 8-10% need a biopsy. Only 20% of those who had a biopsy had cancer.

Just because you need a breast biopsy doesn’t mean you have cancer. Biopsy results will confirm or rule out breast cancer when a specialist examines the cells under the microscope. The majority of people who have a biopsy do not have cancer.

Why choose The University of Kansas Health System for breast imaging?

The University of Kansas Health system is a highly rated, accredited facility where you can conveniently schedule mammograms online. If you are concerned about cost, Kansas and Missouri health insurance plans cover 3D mammograms for more than 1 year from your last imaging appointment. At The University of Kansas Health System, you will receive world-class care by our excellent breast imaging team.