Going for Your First Mammogram? 8 FAQs About What to Expect

Breast cancer screening is the best way to detect cancer early. However, many women put off getting their first mammogram or feel anxious leading up to the appointment.

“Going for that first mammogram can be nerve-wracking, mostly because you don’t know what to expect,” says Amy Martens, MU Health Care supervisor of mammography services. “But the 15 minutes a mammogram takes could save your life. Not a day goes by that we don’t find cancer in a patient.”

The U.S. Preventive Services Task Force recommends that most women begin breast cancer screening at age 40. However, Martens says that if your first-degree family member — such as a mom or sister — was diagnosed with breast cancer, your doctor may recommend a first mammogram 10 years before their age at diagnosis. For example, if your mom received a breast cancer diagnosis at age 45, you might start screening at 35.

To put your mind at ease before your first mammogram, we asked Martens to weigh in on frequently asked questions about breast cancer screening:

1. Do I Need a Referral From My Primary Care Physician or OB/GYN to Schedule a Mammogram?

If you are scheduling a screening mammogram because you’ve reached the recommended age, and not because you have symptoms, you can make the appointment without a referral. A diagnostic mammogram — recommended for breast changes and additional imaging following a screening mammogram — requires a referral.

“Think of a screening mammogram like a yearly check-up,” Martens says. “You feel fine but just want to catch any issues early.”

Scheduling a screening mammogram is as simple as making a phone call. MU Health Care offers same-day scheduled appointments and can typically accommodate walk-ins, but scheduling the screening will eliminate longer wait times.

You can also get screened through MU Health Care’s mobile mammography unit. Businesses can schedule the 34-foot heated and air-conditioned trailer to come to their office so employees can just step outside to get their screening.

2. Can I Get a Screening Mammogram if I Don’t Have Insurance? 

If you are uninsured or underinsured, there are financial resources that help women get mammograms. MU Health Care can connect you with the Show Me Healthy Women program, which provides aid for people meeting specific income and insurance criteria, or other resources that provide free screening mammograms.

“When you call to schedule your appointment, let them know that you don’t have insurance,” Martens says. “They may need to collect additional information before your appointment.”

3. Should I Schedule My Mammogram for a Certain Time During My Menstrual Cycle?

A screening mammogram can detect cancer at any time during your menstrual cycle. However, the Centers for Disease Control and Prevention (CDC) recommends not scheduling your mammogram during the week before your period because breasts tend to be swollen and tender then.

“Your breasts can feel heavier or more sensitive during the second half of the menstrual cycle,” Martens says. “Planning around that time won’t make a difference to the technologist or change the screening outcome, but you might be more comfortable.”

4. Do I Need to Do Anything to Prepare for My Mammogram?

On the day of your mammogram, avoid using lotions, powders or deodorant on your chest and underarms. “Those products can show up as microcalcifications on the imaging,” Martens says. “Those spots mimic breast cancer, and we don’t want to run the risk of a false result.” If you forget and apply one of those products, the imaging center will have wipes to remove it.

You’ll also be asked to undress from your waist up, so pants or skirts may be better than a dress.

5. What Can I Expect When I Go for My Mammogram Appointment?

After you check in, a mammography technologist will bring you to a room. They’ll fill out a health history form with you to assess your breast cancer risk based on:

• Height and weight
• Family history of cancer
• Previous surgeries
• Personal history of cancer

“You’ll provide that health information the first time you come,” Martens says. “Every time after that, we just update the form based on any changes.”

Once the assessment is complete, the tech will step out so you can change into a gown. Then, the tech will perform a 3D mammogram, walking you through each step. The screening itself should take 5 to 10 minutes. Then you’ll get dressed and leave. A radiologist will look at the images within 24 hours and determine whether follow-up is needed.

6. What Happens During the Actual Mammogram?

The tech will have you stand in front of an X-ray machine. You’ll place one of your breasts on a plastic, shelf-like plate. A second plastic plate will gently compress your breast. The goal is to flatten and spread the breast tissue out for the X-ray. You’ll repeat the process with the other breast.

“The mammogram typically involves two views of each breast, but the number of pictures taken can vary based on the breast size and shape,” Martens says. The compression may be uncomfortable, but it shouldn’t be painful. “It’s natural to feel self-conscious, but remember that we do this all day, every day — to us, it’s just another body part. There is nothing to be embarrassed about.”

7. When Will I Get the Results of My Mammogram?

Once the radiologist reviews the images — typically within 24 hours of your mammogram — a nurse navigator will go through the reports, and one of two things will happen:

1. If your tissue looks normal and you don’t require follow-up. Results will be posted on your patient portal, and you’ll receive a letter in the mail. The letter will list your tissue type (whether it is dense) and your risk assessment score.
2. If the images were inconclusive or your tissue looks suspicious, you will require follow-up. The nurse navigator will call you, explain why they need more imaging, answer your questions and schedule your follow-up appointment.

Depending on the situation, a follow-up appointment may involve another mammogram or diagnostic imaging, such as an MRI or ultrasound.

“They may recommend magnification views or spot compressions of an area they need to see more clearly,” Martens says. “Breast tissue is composed of fat and fibrous (dense) tissue. Dense tissue is harder to see through, which makes it more challenging to identify cancer. Extra imaging can help us be sure.”

8. What Are the Next Steps if I Have Dense Breast Tissue or an Increased Risk of Breast Cancer?

Having dense breast tissue or an increased cancer risk does not mean you will be diagnosed with cancer. But it does suggest that you might need more frequent screenings.

“If you have dense breast tissue, discuss your screening plan with your provider, who may recommend additional imaging studies,” Martens says. “People with an increased risk for breast cancer may be referred to our high-risk breast cancer specialist, a nurse practitioner who can guide you on the next steps.”

Next Steps and Useful Resources

• Due for a screening? Schedule a mammogram today.