Starting at age 40—or sooner, based on your personal and family health history—mammography should become a central tool in your annual health checkups. Your health care team will use your mammogram results year after year to:
- Look for changes in your breast tissue over time
- Spot suspicious lumps or masses early in the disease process
- Check up on you after you’ve had breast cancer treatment
Most women are familiar with
screening mammography, an annual exam in which we check for suspicious lumps, masses, or changes in your breast tissue from year to year. Getting a mammogram each year helps us detect changes sooner. That means we can rule out breast cancer faster—or catch it at an earlier, more treatable stage.
If your screening mammogram shows suspicious tissue, we’ll order a diagnostic mammogram to get a closer look at the size, shape, and location of a mass or lump. We can zoom in on specific areas of your breast to help your doctor decide whether you might need a biopsy—taking a small sample of suspicious tissue to test for cancer.
Diagnostic mammography results, combined with other imaging tools, helps your doctor recommend treatment options. For example, I am a breast cancer surgeon, and my team relies on the information we get from diagnostic mammograms to plan effective breast cancer surgeries.
Who should get a screening mammogram?
Age 40 and older with average risk of breast cancer.
Women with no personal or known family history of breast cancer—should get a screening mammogram every year starting at age 40 through your senior years, until you and your doctor agree it is safe to stop.
You should also have a clinical breast exam (CBE) by a health care provider every year. A CBE is when a doctor feels your breasts for lumps, divots, or other abnormal tissue problems.
Age 29-39.
Women in this group should get a CBE every year. Your doctor may recommend starting annual mammograms before age 40 if you are at increased risk for breast cancer.
Risk factors include:
- Family history of breast or ovarian cancer
- Known genetic mutation associated with breast cancer, such as BRCA1 or BRCA2 mutations
- Radiation exposure in childhood
- Personal history of breast or another type of cancer
If you had breast cancer in your 20s or 30s, it is important to get a diagnostic mammogram and a CBE every year to check for changes in your breast tissue.
Women with a family history of breast cancer—a mother, aunt, or sister—may also need annual mammograms before age 40. Talk with your doctor about when you should start getting mammograms and how often.
Please note: Breast self-exams (BSEs) are not a safe substitute for clinical breast exams or mammography. Only advanced imaging can detect small growths or tissue changes deep in the breast. However, it is important to know your own body, and BSE can help you detect lumps or tissue changes between mammograms.
High-tech imaging can be comfortable!
Getting a mammogram is no longer the tedious, uncomfortable experience it used to be. Modern equipment and streamlined scheduling have made getting this important exam quicker and more comfortable than ever before.
Our high-tech mammography equipment delivers clearer imaging, which reduces unnecessary follow-up visits—if we call you back to the office, it’s because we’ve seen something that warrants a closer look.
Two of our new machines are giving patients better experiences with less time spent in the clinic:
- SmartCurve™ Mammography is a revolutionary machine that gives 93% of women a more comfortable 3D mammography experience. The machine’s paddles are curved to fit your breast, which more evenly distributes pressure and reduces pinching. You can get clear, precise imaging while spending less time in the exam.
- Intelligent2D delivers 2D reconstructed images, which show us fine details in the tissue layers of your breasts. Using these images, we can see subtle changes in your breast tissue and potentially detect lesions earlier.
What to expect at your screening mammogram.
A nurse will take you to a private screening room and give you a poncho-like garment to wear. An imaging specialist will help you position your breast between two thin, plastic paddles that are curved like a breast.
The paddles will firmly but gently flatten your breast temporarily while the machine takes images of your breast tissue. It shouldn’t hurt but you might feel a little pinching or discomfort. After a minute or so, the machine will release, and we’ll repeat the process on your other breast.
After the exam, a nurse will call you within 24-48 hours to discuss your results. If your imaging is normal, that’s all you need to do, and we’ll see you next year! If your mammogram reveals a suspicious lump or growth, we will ask you to come back for advanced imaging.
Unusual imaging does not automatically mean you have breast cancer—you may have healthy-but-lumpy or dense breast tissue that requires advanced imaging. But if you do have cancer, your doctor will talk with you about your treatment options. When caught early, breast cancer is highly treatable. Your dedicated team of breast cancer experts will work together to give you the very best breast cancer care, which may include a combination of chemotherapy, radiation therapy, and/or surgery.
How breast surgeons use diagnostic mammogram results.
When we look at your imaging prior to surgery, we are looking for abnormal calcifications or abnormal shapes in the breast tissue. Having calcifications does not mean that you have breast cancer, but it can indicate changes in your breast tissue over time—another reason to get a mammogram each year.
If your diagnostic mammogram clearly shows a mass, we use the results plus more advanced imaging to analyze its size and location. Mammogram results help breast surgeons determine which advanced imaging tests we need to order for surgical planning, such as:
- Ultrasound allows us to examine nearby lymph nodes to which the cancer may have spread.
- CT scans can help us determine whether the cancer has spread to far away lymph nodes or organs.
- Breast MR, a non-invasive, radiation-free imaging tool, can give us a better view of dense breast tissue, which helps us create a map of your breast for surgery.
Mammography’s role after breast cancer surgery.
The American Cancer Society does not have specific guidelines for mammography after breast cancer surgery. The types and extensiveness of surgeries vary, as do patients’ personal needs and risk factors.
MedStar Health patients typically see their surgeon for follow-up six months after breast cancer surgery. Then, we will want to see you each year for five years post-surgery—the highest risk period for cancer to return. Diagnostic mammograms may be part of your follow-up care, depending in part on the type of surgery you had:
- Full mastectomy with or without reconstruction: You are done with mammograms for the rest of your life. Generally, women with fully reconstructed breasts do not have enough remaining tissue to warrant mammography. However, you will need regular physical exams to ensure no tumors develop in your chest tissue.
- Unilateral mastectomy: If you had one breast removed, you will need an annual mammogram of the remaining breast and a regular exam of the chest tissue that remains after surgery.
- Lumpectomy: If you had just the diseased portion of one or both breasts removed—which is the procedure 60-70% of our patients choose—you’ll need a diagnostic mammogram annually.
We can schedule your surgical follow-up visits and mammograms for the same day so you can get the care you need in fewer trips. Your surgeon will work with the radiology team to ensure you get the most accurate imaging exams.
Though getting a mammogram isn’t anyone’s idea of fun, it’s an essential exam to protect your breast health. If you feel a suspicious lump, don’t wait until your next well-woman visit to get it checked out. Schedule a mammogram—it’s better to know than to leave a potential tumor untreated.
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