Mammograms: The Not So Scary and Necessary Cancer Screening Tool

By Robyn Fuller-Christenson, DNP
Medically reviewed
October 28, 2021

The Mammogram

Let’s face it, once we reach a certain level of “seasoning” or age in life or when instructed by our healthcare provider, to obtain a mammogram, it can be a very scary thing the first time you have to have one done. Despite how nice the mammographer may be, you are still fearful that it may be painful to have your “boobs squished” as described by many of your friends and family members. You may also be nervous about the results depending on your family history, risk factors, or if this mammogram was ordered based on an abnormal breast finding. 

There are also different types of mammograms performed and results have different meanings. You may even receive a result via a phone call, voicemail, or in the mail, but what does it all mean? Finally, you may be provided different routine mammogram screening schedules that may differ from what your grandmother, your mother, or what you may have previously done, and you may wonder why? Mammograms are an extremely important tool in early detection, which is vital in improving survival rates for breast cancer patients.

In This Article We’ll Explore:

  • The Different Types Of Mammograms
  • What To Expect During A Mammogram
  • Screening Guidelines For Average Risk Individuals
  • Things That May Affect The Accuracy Of Mammograms 
  • Healthcare Provider Follow Up
  • How K Health Can Help

Types of Mammograms

Before we get into the different types of mammograms, let’s stop for a second and define mammograms. A mammogram is an x-ray of the breasts. The amount of radiation used in mammograms is very small, but mammograms are able to locate a mass before it is able to be felt by the human hand. 

Screening mammograms are performed routinely checking for signs of breast cancer in individuals with no symptoms. 

A diagnostic mammogram is like a screening mammogram but may be done as a follow-up to an abnormal screening mammogram or clinical breast exam. It is the same process as the screening mammogram except more pictures are taken and they are tailored to a specific area of concern. It is also usually done in accordance with another breast imaging exam (ultrasound or MRI) or biopsy. Please remember a diagnostic mammogram cannot diagnose breast cancer.

  • Traditional Film Screen: Traditional Mammography on plain X-ray films. Unable to lighten, darken, highlight, or zoom in on areas of suspicion. Has a higher recall rate for patients to return for additional imaging or testing.
  • Digital: Newer form of mammography. Digital films stored on computers. Allows images to be enhanced, lightened, darkened, or shared with others. They have been proven to detect breast cancer better in women under 50, women with dense breasts, and premenopausal women (women still having menstrual periods).
  • Digital Tomosynthesis (also called 3D Mammogram): Newest and latest type of mammography. Sensitive enough to detect abnormal cancerous tissues from non-cancerous tissues as well as subtle abnormalities that would normally be missed in a traditional mammogram. This technique has also reduced the rate of unnecessary callbacks to patients.

What to Expect During Your Mammogram

A screening mammogram takes about 15 to 20 minutes. Each breast is placed between two plates and compressed (pressed between the two plates). You may feel some slight discomfort. If you are concerned about discomfort, please discuss taking an over-the-counter Tylenol (Acetaminophen) or Advil (Ibuprofen) with your healthcare provider. Two pictures will be taken of each breast, one from top to bottom and the other side to side. The mammographer will reposition you each time. 

The number of pictures may change depending on factors such as breast implants and if you are having a diagnostic mammogram instead of a screening mammogram (this may lengthen the time frame by a few minutes). 

Most individuals receive their results within two weeks.

Preparing For Your Mammogram

  • Try to schedule your mammogram one to two weeks after your menstrual period when your breasts are less likely to be tender (if still having menstrual periods).
  • Call ahead and notify staff if you have breast implants to ensure a mammographer competent in your care is available. Also notify the facility of other breast surgeries.
  • Please notify the facility and mammographer if you are breastfeeding. 
  • If you are pregnant or believe you may be pregnant, please notify the facility (before making an appointment) and your doctor’s office to discuss other options.

Day of Your Mammogram

  • Avoid deodorant, powder, lotions, perfumes (these products can show up on the mammogram and make it harder to read).
  • You will undress from your waist up, so wear a shirt and bra that are easy to remove. You will be given a patient gown to wear open to the front and a locker to place your items. It is best to leave jewelry and valuable items at home.

Recommended Mammography Screening Guidelines for Average Risk Individuals

Things That May Affect Mammogram Results

Vaccinations

During this Covid-19 pandemic, many individuals have received at least one dose if not both doses of the Covid 19 vaccine. Enlargement of lymph nodes under the arm is a common side effect of the vaccine. This can be problematic when having a mammogram as lymph node enlargement can be a sign of breast cancer and lead to additional imaging, testing, and patient anxiety.

Therefore, the recommendation per the Society of Breast Imaging is:

  • Screening Mammogram 
    • Unvaccinated: Schedule mammogram prior to first dose of Covid 19 vaccine.
    • Partially or Fully Vaccinated: Schedule mammogram 4 to 6 weeks after last dose of Covid 19 vaccine (allows lymph nodes time to return to normal size). 
  • Diagnostic Mammogram: If you are having symptoms do not delay. 
  • Other vaccines that can cause similar symptoms include shingles, flu, pneumonia, DTAP/TdaP, as well as receiving more than one vaccination at a time. If receiving a screening mammogram, please follow the recommended guidelines above.

Breast Implants

It is safe to receive a mammogram while having breast implants; however, it may be harder to detect any abnormalities as breast implants can hide breast tissue. Please call ahead and attempt to find a center skilled in working with individuals with breast implants and remind the mammographer the day of your appointment so that she properly positions you and captures four images instead of the traditional two images.

Dense Breast Tissue

Women with dense breasts have a higher risk of developing breast cancer. It is also harder to find cancerous masses in dense breasts on mammograms. Some state laws require patients to be notified if they have dense breast tissue, so please follow up with your healthcare provider to find out your state law regarding notification of dense breast tissue. If you have a history of dense breast tissue and have an appointment with a new healthcare provider, please be sure to inform the provider so that the proper mammogram (Digital or Tomosynthesis) is ordered for you.

Breastfeeding

Breastfeeding makes breast tissue appear denser on mammograms; therefore, it is best to stop breastfeeding prior to a screening mammogram. If you are due for a screening, please follow up with your healthcare provider to discuss the best timing. If you have concerning findings in your breast while breastfeeding, follow up with your healthcare provider immediately.

Healthcare Provider Follow Up

  • Please follow up with a healthcare provider if you have questions about your personal risk factors for breast cancer and when and how often you should receive a mammogram.
  • If you have concerns about any abnormal changes in your breasts.
  • If you receive an abnormal result on your mammogram or any breast imaging or testing.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Robyn Fuller-Christenson, DNP

K Health-affiliated clinician Robyn Fuller-Christenson, DNP, is a double board-certified Family and Women’s Health Nurse Practitioner with over 7 years of primary care, urgent care, and obstetrics and gynecology experience. Prior to becoming a nurse practitioner, Robyn spent over 4 years working as a certified operating room registered nurse in various level one trauma centers across the country. She received her bachelor’s degree from Baylor University. She then attended Vanderbilt University where she obtained her master’s degree in family nurse practitioner, doctor of nursing practice degree, and a postgraduate certificate in women’s health nurse practitioner.