What to Expect at Your First Mammogram Appointment

As a middle-aged woman, you are likely in the busiest season of your life and not thinking about your own health care.

However, a mammogram screening is one of the most effective tools for the early detection of breast cancer, and if cancer is found, early detection greatly increases the chances of successful treatment.

By taking the time for a mammogram, you are taking a proactive step in your health and protecting yourself and your family from a more serious health concern.

Being well-informed before your mammogram appointment is crucial in making this experience as seamless as possible.

Knowing what to expect before your mammogram can help ease your anxieties and create a more comfortable experience for you.

Why is it important to get a mammogram at age 40?

According to the latest research, starting regular mammograms at age 40 is recommended for all women.

At this age, your risk of developing breast cancer increases. Regular mammograms can detect potential issues before they become more serious.

Talk to your doctor about your risk factors at your age and how often to schedule mammograms now and in the future.

How should I prepare for my first mammogram?

Your doctor may have the best advice on when and where to schedule your mammogram, what you need to bring, and how to prepare on the day of the appointment.

Here are some general guidelines to help you prepare:

• Gather your medical records: If you’re visiting a new facility for the first time, bring any documentation of previous breast-related records including mammograms or biopsies.
  
  
• Timing matters: Avoid scheduling your mammogram for the week before your menstrual period, as breasts can be more sensitive during this time.
  
  
• Choose a facility: If possible, it’s best to stick to the same facility year after year to make it easy to compare previous mammograms, and to become familiar with the staff and environment. Choose a facility that is convenient for you now and in the future.
  
  
• Dress comfortably: On the day of the exam, keep in mind that you will remove your top and bra for the mammogram, so avoid dresses or one-piece outfits to make the process easier.
  
  
• Avoid certain products: On the day of the exam, don’t wear deodorant, powders, lotions, perfumes, or any other products to your underarms, chest, or surrounding areas.

Some of these products contain substances that can appear as white spots on the mammogram, potentially interfering with the reading, or providing inaccurate results. You can bring any products with you to apply for after the exam.

What type of doctor should I see for my mammogram?

Your primary care physician or gynecologist can help you schedule a mammogram or refer you to a specialist.

A radiologist is typically the medical professional who will perform and read the mammogram, but your primary care doctor or gynecologist will be the one to discuss the results with you.

What should I expect at the appointment?

Remember that your healthcare providers do not expect you to know how the exam will go, and they will explain everything you need to know at the appointment.

This is what a typical mammogram appointment includes.

After you check in, you will be taken to an exam room, where you will be provided with a gown to change into from the waist up.

A health care professional, usually a radiologic technologist, will review your medical history and ask about any related symptoms or concerns you may have.

You will then be led to the mammography room with a specialized X-ray machine for breast imaging.

Your technician will help position you for the X-ray to ensure clear, accurate images. The whole appointment can take about 20 minutes, while the mammogram itself typically takes less than 30 seconds.

What should I expect for the follow-up process?

In most cases, you can expect to receive your mammogram results within a few weeks. A full report of your results will be sent to your health care provider, and they will contact you to discuss the results.

If the results are normal, you’ll be advised to schedule your next mammogram, usually in one to two years.

If there are any abnormalities or if the images aren’t clear, your doctor will discuss additional tests or procedures.

Keep in mind that even a small abnormal spot can be a reason for another mammography or test. An abnormality does not always mean cancer.

According to Cancer.org, fewer than 1 in 10 women called back for more tests are found to have cancer.

Getting called back for additional testing is more common after your first mammogram, especially if there are no prior mammograms to compare it to.

Women who have not yet gone through menopause are also more likely to get a call back about their results.

What do mammogram results mean?

Receiving the results of your mammogram can be both a relief and a source of anxiety. Discussing the results with your doctor can help ease your worries, and help you understand any next steps if needed.

Health care professionals use the Breast Imaging Reporting and Data System to grade mammogram findings and results. Here is an overview of possible results from your mammogram: **

0 - Incomplete: This result means that the radiologist has identified something that needs further testing, but it wasn’t clear from the initial mammogram. Additional tests, like another mammogram are needed.

It could also imply that the radiologist wants to compare your new mammogram with older ones to track changes over time.

1 - Negative: A negative result is considered a normal finding. It means nothing new or abnormal was found.

2 - Benign (non-cancerous) finding: This result means there’s no sign of cancer, but the radiologist saw something that is non-cancerous.

This could be benign calcifications, masses, lymph nodes, or simply changes from a prior biopsy. Your radiologist may note this so future health care providers will not misinterpret the benign finding as suspicious.

3 - Probably benign finding – Follow-up in a short time frame is suggested: These results have a very low chance of being cancer, no more than 2%.

But since there is uncertainty, your doctor will recommend follow-up mammograms every 6-12 months for at least 2 years.

This is to ensure the mass or spot does not change over time.

4 - Suspicious abnormality – Biopsy should be considered: These results mean there is a finding that doesn’t definitively look like cancer but enough to recommend a biopsy.

These results are categorized as follows:

- 4A: Low likelihood of cancer (more than 2% but no more than 10%)

- 4B: Medium likelihood of cancer (more than 10% but no more than 50%)

- 4C: High likelihood of cancer (more than 50% but less than 95%), though not as high as Category 5

5 - Highly suggestive of malignancy – Action should be taken: In this category, results strongly resemble cancer, with at least a 95% chance of being cancer. A biopsy is strongly recommended soon to create an action plan.

6 - Known biopsy-proven malignancy – Appropriate action should be taken: This is used when the findings have already been confirmed as cancer through a previous biopsy. The imaging may be used to monitor treatment progress.

Understanding these categories is crucial for interpreting your mammogram results.

If your results fall into any category other than "Negative" or "Benign," your healthcare provider will guide you through the appropriate next steps, which may include additional tests or procedures to ensure your breast health is closely monitored and any concerns are addressed promptly.

* https://effectivehealthcare.ahrq.gov/products/breast-biopsy-update/clinician

** https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/mammograms/understanding-your-mammogram-report.html