What to expect during and after a mammogram

It's a test that often gets a bad rap for being uncomfortable and embarrassing. But truth is, mammograms save lives.

In fact, since mammography screening became widespread in the mid-1980s, the breast cancer death rate has dropped nearly 40% in the U.S., based on National Cancer Institute data. That stat speaks to the power and importance of this safe and effective screening and diagnostic procedure.

“Breast cancer is a completely treatable disease when caught early enough that it can be removed surgically before it spreads. But typically, a cancer of these smaller sizes is not palpable, meaning it's not easily detectable via a self-exam or doctor's exam,” says Dr. Evita Singh, a diagnostic radiologist and clinical assistant professor for Michigan State University College of Human Medicine in Detroit.

On the other hand, mammograms, which use relatively safe, low-dose ionizing radiation in the form of X-rays, do a better job revealing tumors and problems when they are small and easier to treat via less invasive measures.

“Overall, mammography will find about 85% of breast cancers in women. And women who choose to have regular yearly mammograms, as recommended, will likely increase their chance of surviving breast cancer by about 50%,” says Dr. Daniel Herron, a diagnostic radiology specialist in Carmichael, California.

The procedure itself is relatively straightforward.

“The day of your screening mammogram, you are discouraged from wearing deodorant or lotions that can potentially interfere with the imagery,” says Dr. Jane Mendez, a surgical oncologist at Miami Cancer Institute in South Florida. “When you arrive for your appointment, you'll probably be asked questions about your personal and family history of breast cancers. The technician will examine the questionnaire and may review it with a radiologist while they are performing the mammogram.”

Next, you'll be asked to disrobe from the waist up and wear a gown. Your breast will be placed in the mammogram machine. The technologist operating it will move the machine's paddles to compress your breast for a few seconds, keeping it still and improving imaging results. You may be asked to hold your breath while images are taken.

“Two views of each breast are taken — a top-to-bottom view and a side-to-side view,” says Dr. Sarah Friedewald, chair of the Breast Imaging Communications Committee of the American College of Radiology. “Sometimes the machine will move in an arc across the breast to acquire images, which is called tomosynthesis, or 3-D mammography.”

If it's standard 2-D imaging, usually two images of each breast — four images total — are taken.

Mendez explains that the procedure can differ slightly if you're having a diagnostic mammogram — meaning the radiologist or your doctor has already detected a lump or other problem.

“Diagnostic mammograms may sometimes include additional views and an ultrasound for further evaluation,” says Mendez. “A diagnostic mammogram has to be evaluated the same day, so you'll know the results before you leave and be instructed about the next steps.”

But if it's a screening mammogram, you'll go home and await the results.

“Your mammograms are interpreted by a radiologist, a physician who specializes in imaging. Results are typically reported to your doctor's office within 24 to 48 hours,” says Singh.

By law, the results must be communicated to you no later than 30 days after the exam.

“Most of the time, benign results come in the form of a letter or email,” says Friedewald. “But, you'll be called by phone if additional tests are necessary.”

This can occur if you have dense breast tissue, which appears whiter in color, making it more challenging to observe white-colored cancer.

Friedewald cautions that it may take a bit longer nowadays to get an appointment and complete your procedure due to COVID-19 complications.

“Many facilities are trying to reduce patient contact and allow extra time to clean equipment, exam rooms and other areas, so they're often scheduling more time between each appointment,” says Friedewald.

Be prepared to wear a mask, have your temperature taken, and answer coronavirus screening questions before the procedure, Mendez adds.