A mammogram is a specialized X-ray used as a primary screening tool for the early detection of breast cancer. This imaging procedure utilizes low-dose radiation to create images that a radiologist analyzes for abnormalities like masses or microcalcifications. Mammograms can often identify changes years before a physical lump can be felt. Regular screening is a proactive step, offering the best opportunity for successful treatment.
Determining Screening Eligibility and Frequency
Establishing the correct screening schedule begins with understanding medical guidelines, which can vary. The United States Preventive Services Task Force (USPSTF) advises women to receive a screening mammogram every two years starting at age 40. The American Cancer Society (ACS) suggests women aged 40 to 44 should have the choice to begin annual screening, and recommends annual mammograms for women aged 45 to 54.
Women aged 55 and older can generally switch to screening every two years, or continue with yearly exams, as long as they are in good health. Personal risk factors, such as a strong family history of breast cancer or a known genetic mutation, may necessitate starting screening earlier. Consulting a primary care provider is the best way to determine a personalized screening schedule based on individual risk assessment.
Step-by-Step Guide to Scheduling
Scheduling begins by determining if a referral is required, which depends on the type of exam. A routine screening mammogram for asymptomatic women typically does not require a physician’s order, allowing for self-scheduling directly with an imaging center. A diagnostic mammogram, performed to investigate a symptom like a lump or to follow up on an abnormal screening result, almost always requires a referral from a healthcare provider.
When selecting a facility, verify that it is certified under the Mammography Quality Standards Act (MQSA) and ideally accredited by the American College of Radiology (ACR). ACR accreditation confirms the facility meets rigorous standards for personnel qualifications, equipment quality, and image quality. This information can often be found in a searchable database maintained by the FDA or the ACR.
Contact the scheduling department prepared with specific information. Have your insurance card ready to verify coverage and determine potential out-of-pocket costs, as coverage for 3D mammography can vary. If you have had previous mammograms at a different location, arrange for the transfer of those records before your appointment, as the new facility needs them for comparison.
Preparing for the Mammogram Appointment
Preparation on the day of the exam focuses on preventing image interference and maximizing comfort. It is important to wear a two-piece outfit, such as a top and pants or a skirt, as you will only need to remove clothing from the waist up. This allows you to remain partially dressed throughout the procedure.
You must avoid applying any deodorant, antiperspirant, powder, lotion, or perfume to the chest or underarm area before the exam. These products contain metallic substances that can appear as tiny white specks on the X-ray image. These specks can mimic microcalcifications, potentially leading to a false-positive result and requiring unnecessary follow-up testing.
For pre-menopausal women, scheduling the mammogram for the week following the menstrual period may reduce breast tenderness and discomfort during the compression phase. If you forget to skip topical products, most facilities will provide wipes to clean the area. Bringing a list of any prior breast surgeries, biopsies, or concerns is also helpful for the technologist and the interpreting radiologist.
Understanding Results and Follow-Up
The results are interpreted by a radiologist and typically sent to your healthcare provider within two weeks. Findings are standardized using the Breast Imaging-Reporting and Data System (BI-RADS), which assigns a category score from 0 to 6. Scores of 1 or 2 indicate a normal or benign finding, meaning routine annual screening should continue.
A BI-RADS score of 0 means the image is incomplete or unclear, requiring additional imaging like a diagnostic mammogram or ultrasound. Scores of 4 or 5 suggest a suspicious finding that may require a biopsy. Receiving a call back for further imaging requires prompt follow-up, but does not automatically mean cancer is detected.