What to expect at your mammogram

If you’re between ages 40 and 45, your doctor has likely advised you to schedule a screening mammogram. This test is one of the most important tools for finding breast cancer in the early stages, when it’s easier to treat. Before you get a mammogram, knowing what to expect is helpful.

At Aurora Health Care, we offer no-referral screening mammograms in multiple convenient locations close to where you live and work. With online scheduling, we aim to make it as simple as possible to get the care you need when and where you need it.

How to prepare for a mammogram

Most women don’t need to do anything specific to prepare for a mammogram. But following a few pointers can help your appointment be more productive. You may:

• Bring deodorant, in case you’re not going directly home after your appointment
• Dress in a two-piece outfit, as you’ll need to undress from the waist up
• Send records of previous mammograms if you’ve had testing at other facilities

What should you not do before a mammogram?

Deodorants, creams, lotions and perfumes can appear as white spots on your mammogram, so you should avoid wearing them on your underarms and breasts. Solid masses also show up as white spots, and you want your results to be as clear as possible.

If you’re not heading home after your mammogram, you may bring deodorant to apply afterward. If your appointment is later in the day, you may also bring or ask for a cleaning wipe to remove deodorant.

What happens during a mammogram?

On the day of your mammogram, you complete paperwork to describe your medical and family history. Let your technologist know if you:

• Are breastfeeding
• Are or could be pregnant
• Have breast implants
• Have trouble standing upright or holding still without assistance
• Have noticed any recent changes in your breasts

You undress from the waist up, put on a gown and go into the room with the mammogram machine. During the test, your technologist:

1. Positions each breast on the lower plate of the mammography machine
2. Moves the upper plate (compression paddle) of the machine down to compress your breasts
3. Takes X-ray images of your breast tissue. You may need to hold your breath for several seconds while the technologist takes the X-rays.

How long does a mammogram take?

Most screening mammogram appointments last around 30 to 45 minutes. But your breasts are only compressed for 10 to 15 seconds per image. Women with an average risk of breast cancer typically need two images per breast.

A diagnostic mammogram appointment will last longer. The time can vary depending on how many images the technologist needs to take.

What happens during a mammogram if I have breast implants?

Let your technologist know beforehand if you have breast implants. They’ll need to use a special technique and take more pictures of your breasts.

Instead of two X-ray images, you’ll have eight. Your technologist takes four images with the compression paddle on top of your breast. Then they use a method called the Eklund technique to pull your skin forward and push the implant back. This technique allows your breast tissue to be compressed so that you get a clear, detailed image.

Is mammogram screening painful?

Mammograms are often uncomfortable, and some women describe them as painful. You may even feel apprehensive about the discomfort of breast compression.

It’s important to understand that compression, or “squishing” the breast, is vital to getting a clear, accurate image. Breast compression helps to:

• Create uniform thickness of your breast tissue
• Decrease radiation dose
• Enhance detail by bringing your breast close to the imaging device
• Minimize radiation to other parts of your body
• Prevent movement, which could result in blurry images and the need for retesting
• Separate the breast tissue from other tissues so your doctor gets a clear view

How to minimize pain during a mammogram

Remember that the actual breast compression time lasts less than a minute. But if you are in pain, tell your technologist. They may be able to adjust the compression or use other techniques to make the experience more comfortable.

A few tips can also help minimize pain, such as:

• Don’t schedule mammograms when your breasts may be tender, such as during your period or the week before
• Limit caffeine and sodium, which can make your breasts more tender
• Practice deep breathing or visualization techniques
• Request gradual compression, which may be more comfortable than sudden compression
• Take an over-the-counter pain reliever about 45 to 60 minutes before your appointment

Mammogram results

A radiologist (doctor who specializes in medical imaging) interprets your mammogram results. An important part of interpreting the mammogram is comparing it with past mammograms. This comparison can show small changes that could be a sign of cancer.

Your mammogram results may show:

Breast density

Dense breasts have more fibrous and glandular tissue than fatty tissue. Having dense breasts is normal, but it can be harder to spot an abnormal mass on a mammogram if you have dense breasts. Dense breasts have also been linked to a slightly higher risk of breast cancer. Your doctor may recommend additional screenings if your mammogram shows very dense breast tissue.

Calcifications

Calcifications are small mineral deposits that look like white spots on a mammogram. There are two types of calcifications:

• Macrocalcifications are larger mineral deposits, but they’re not cancerous. They may develop because of old injuries, inflammation or aging. About 10% of women under age 50 have macrocalcifications, and about half of all women over 50 have them.

• Microcalcifications are tiny calcium deposits. They aren’t always cancer but may require further testing. You may also need a biopsy to get more detail. In a biopsy, your radiologist takes a small piece of breast tissue to analyze under a microscope.

Masses

A mass is any area that doesn’t look as expected on your mammogram. It’s important to remember that a mass doesn’t always mean cancer – noncancerous and cancerous masses tend to look the same on a mammogram.

A mass may be a:

• Cyst, a fluid-filled sac that is rarely cancerous
• Noncancerous (benign) tumor
• Cancerous (malignant) tumor

Your provider may recommend further testing, such as a biopsy, MRI or ultrasound, if your mammogram shows a mass. They may also recommend a “watchful waiting” approach, where you get a mammogram again at a later date to see if the mass has changed.

How long does it take to get mammogram results?

At Aurora Health Care, we aim to get your mammogram results back to you on the same day as your appointment. You’ll receive same-day results if you:

• Complete your mammogram before 2 p.m. on a Monday through Friday
• Have previous mammogram results on file with us
• Have a LiveWell account

If you have your mammogram after 2 p.m. or on Saturday or Sunday, we will get your results back to you the next business day.

What does it mean if I get a callback for additional testing?

A callback after a mammogram means your doctor wants you to get further testing. Callbacks are common, and they don’t necessarily mean you have cancer. You may need another mammogram to get clearer images, or your doctor may order additional tests such as an ultrasound or MRI.

Callbacks are also common after your first mammogram. Comparing current to past mammograms is an essential part of interpreting the results. So, if you’ve never had a mammogram, your doctor may order more tests to establish a "baseline."