by Dr. Carol Koeble, MD, MS, CPE, FACOG, regional medical director at Blue Shield of California
This news story is also available in Spanish.
People delay preventive care for many reasons: “I’m in good health.” “My family history is just fine.” “It takes too much time to go to the doctor.” Whatever reasons you give yourself, the truth is that preventive care can save lives.
When it comes to breast cancer, preventive screenings are essential — early detection and treatment significantly increase survival rates. Breast cancer is one of the most common forms of cancer, accounting for one in three diagnoses among women, with the majority having no family history. Many people avoid mammograms because they worry about discomfort, or the time and effort involved. While these are understandable, the procedure is quick — about 15-20 minutes total — and the potential lifesaving benefits outweigh the temporary discomfort. Breast Cancer Awareness Month is an important reminder to schedule your mammogram.
Here are some of the most frequently asked questions about mammograms to help you understand what to expect before, during and after the procedure.
1. What is a mammogram?
A mammogram is a specialized X-ray imaging test that examines breast tissue for abnormalities, such as lumps, masses, calcium deposits and structural changes.
2. When should I get a mammogram?
Women over the age of 40 who have an average risk of breast cancer — those with no personal/family history, genetic predisposition or chest radiation therapy before age 30 — are typically recommended to get annual or bi-annual mammograms. Women aged 55 and older may consider switching to every other year if they’re in good health. Guidelines vary depending on personal and family history and other risk factors. Discuss with your doctor if you need more guidance about frequency.
3. What risk factors make me eligible for a mammogram more often or earlier than age 40?
Speaking to a doctor about the potential risks and benefits of screening at a younger age can help you make the right decision. Various risk factors increase a woman’s likelihood of developing breast cancer, such as:
- Family history: If immediate family members were diagnosed with breast cancer, especially anyone at a young age, or if multiple family members have been diagnosed, you may be at higher risk.
- Genetics: People with certain genes, such as BRCA1 or BRCA2, are at increased risk. Ask your doctor about options for genetic testing.
- Reproductive history: Women who started their period before age 12 or menopause after age 55 may be at higher risk.
4. How do I prepare for a mammogram?
Try to schedule the appointment when you’re not menstruating to avoid your breasts feeling tender or swollen. Consider wearing a two-piece outfit, as you’ll need to remove your top for the test. Do not apply deodorant or creams under your arms, as those products may appear on the X-ray and interfere with results. See more advice from the American Cancer Society here.
5. What does a mammogram entail?
The screening typically takes about 20 minutes. You’ll undress from the waist up, and the technologist will place your breast in the mammogram machine, which compresses your breast as they take an X-ray. You’ll then switch positions for another image to be taken from a different angle.
The plastic plates that compress the breast can cause some discomfort, though only for a few moments. Some women report they aren’t bothered at all, but if you are feeling uncomfortable, it’s important to speak up, as technicians may be able to help manage this.
6. Are there different types of mammograms?
Mammograms are offered in 2D, the standard method, or 3D, which involves taking multiple, more detailed images from different angles. If you have dense breasts, like about half of women over age 40 in the U.S., it may be tougher to see abnormalities and your doctor may additionally recommend a breast ultrasound or other testing. As of September 2024, all mammogram reports in the U.S. must include breast density results.
7. What if something abnormal is found?
Finding something abnormal doesn’t always mean you have breast cancer. Follow-up imaging with a diagnostic mammogram or breast ultrasound can help determine the cause of the irregularity. If follow-up imaging suggests cancerous cells, your provider may recommend a biopsy, a procedure to remove a piece of tissue or a sample of cells so that it can be tested in a laboratory.
8. Should I be doing self-exams?
Yes, you should be doing self-exams, as it can help track changes to the breast. However, self-exams do not replace a mammogram, which can find potential cancer years before lumps or other physical symptoms occur.
9. Do I need a referral to schedule a mammogram?
If you are under 40, you will need a referral from your primary care physician or gynecologist that includes your risk factors. If you are over 40, you typically don’t need a referral. You’ll schedule your mammogram through your gynecologist or primary care provider, but the exam will be with a technologist or radiologist. This may vary depending on your age and risk factors.
Resources
- Schedule a mammogram with your provider today: Blue Shield of California, Find A Doctor
- Open enrollment: Preventive care, including breast cancer screenings and mammograms, is typically covered at no out-of-pocket cost. Fall is open enrollment season, be sure you have the best health plan for your needs and preventive care. For more tips and information to help navigate open enrollment, check out this News Center story.