“Once you’ve had the 1st mammogram, the anxiety will lessen.”
It’s common to be nervous before your first mammogram. You’ve likely seen photos of people getting mammograms, and it’s easy to let your mind run wild about what it actually feels like.
“For women who are anxious about having a mammogram, I think it's important to remember that once you've had that first mammogram, the anxiety will lessen with subsequent mammograms, and the benefit of having the mammogram far outweighs the risk of breast cancer death,” says Brenda Panzera, MD, oncologist at Mount Sinai Hospital and Lenox Hill Hospital.
What Happens at a Mammogram
At the radiology office, you will be asked to undress from the waist up. It’s helpful to wear pants or a skirt—as opposed to a dress—so you only have to remove your top. In fact, some places may give you a hospital gown that only covers your top half, so being able to wear your pants could save you some awkwardness. (Learn more tips to prepare for a mammogram here.)
Next, you will be guided to the mammogram machine, which contains two parallel plates. “The X-rays are usually performed by compressing the breast tissue [between the plates], which for some can be uncomfortable momentarily,” says Dr. Panzera.
How uncomfortable? It depends. Some people say it’s no biggie—just a little pressure. If the compression feels painful, however, speak up: Your technician can help adjust your breasts or the plates to make it more comfortable, as it’s not supposed to cause pain.
As uncomfortable as the compression may be on your breasts, it’s for a good reason. “The better compression that's achieved results in better films and a better ability to detect if there's any abnormalities,” says Dr. Panzera. The compression also helps hold the breasts still to reduce blurring on the X-ray image.
What Doctors Are Looking For
“A radiologist is looking for many different things when they're looking at a mammogram,” says Dr. Panzera. “They are looking to see if there are any visible abnormalities on the X-ray.”
“Visible abnormalities” may include things like:
Calcifications, or calcium deposits in the breast tissue. These are often benign, but can sometimes indicate breast cancer.
Masses or nodules, or an area of dense breast tissue with irregular borders.
Any changes compared to previous mammograms. “Oftentimes, that's one of the earliest signs that something may be happening is that if there's a subtle change between the two images,” says Dr. Panzera.
If an abnormality is found, you may be called back for additional X-rays or ultrasounds. Keep in mind that this does *not* necessarily mean you have breast cancer. In fact, around nine out of 10 of women called back after a mammogram are found to not have cancer, according to the American Cancer Society (ACS).
When Mammograms Are Recommended
“The benefits of screening are early detection of breast cancer. Screening, however, does not come without some risks, and those risks need to be explored with that individual so that they can make a personalized decision,” says Dr. Panzera.
For people with an average risk of breast cancer, the ACS recommends breast cancer screening every year for women between the ages of 45 and 54 (although you have the option to begin screening at age 40). Those who are considered to have a high risk for breast cancer may begin as early as age 30.
Dr. Panzera is a clinical instructor in hematology and oncology at the Mount Sinai School of Medicine, and attending physician at Mount Sinai and Lenox Hill Hospitals.
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Besides the breast self-exam, and the doctor's examination,
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there are other techniques that fit into the vital program of early detection.
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They involve taking pictures of the breasts.
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The mammogram, or X-ray, gives the doctor a thorough look
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at the entire breast tissue.
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For women who are anxious about having a mammogram,
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I think it's important to remember that once you've had that first mammogram,
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the anxiety will lessen with subsequent mammograms,
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and the benefit of having the mammogram far outweighs
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the risk of breast cancer death.
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Typically, what will occur is someone will go to a radiology office.
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They will get undressed from the waist up,
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and they will have X-ray pictures taken of their breast tissue.
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The X-rays are usually performed by compressing the breast tissue,
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which for some can be uncomfortable momentarily,
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but the better compression that's achieved,
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results in better films and a better ability to detect
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if there's any abnormalities.
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A radiologist is looking for many different things
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when they're looking at a mammogram.
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They are looking to see if there are any visible abnormalities on the X-ray.
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Things such as calcifications can sometimes be a marker for further investigation.
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A nodule that does not appear to be clearly circumscribed
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but has irregular borders.
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They're looking to compare if somebody's had previous imaging.
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It's very important that they compare the previous imaging
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to the recent imaging to see if there's been any changes.
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Oftentimes, that's one of the earliest signs that something may be happening
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is that if there's a subtle change between the two images.
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In terms of when we recommend that women begin breast cancer screening,
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between the ages of 40 and 49.
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Healthcare professionals will usually speak with women
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about the pros and cons of screening beginning at that age.
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The benefits of screening are early detection of breast cancer.
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Screening, however, does not come without some risks,
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and those risks need to be explored with that individual
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so that they can make a personalized decision.
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American Cancer Society recommendations for the early detection of breast cancer. Atlanta, GA: American Cancer Society, 2019. (Accessed on January 17, 2020 at https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html.)
Getting called back after a mammogram. Atlanta, GA: American Cancer Society, 2019. (Accessed on January 17, 2020 at https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/getting-called-back-after-a-mammogram.html.)
Mammogram basics. Atlanta, GA: American Cancer Society, 2019. (Accessed on January 17, 2020 at https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/mammogram-basics.html.)
Mammogram - calcifications. Washington, DC: MedlinePlus, U.S. National Library of Medicine. (Accessed on January 17, 2020 at https://medlineplus.gov/ency/article/002113.htm.)
Mammography. Bethesda, MD: National Institute of Biomedical Imaging and Bioengineering. (Accessed on January 17, 2020 at https://www.nibib.nih.gov/science-education/science-topics/mammography.)
What does the doctor look for on a mammogram. Atlanta, GA: American Cancer Society, 2019. (Accessed on January 17, 2020 at https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/what-does-the-doctor-look-for-on-a-mammogram.html.)