What to Expect at Your First Mammogram

While we know that women at average risk for breast cancer should start annual mammograms at age 40, it can be difficult to make the time, especially when you’re uncertain about what to expect. Busy lives and questions like what should I wear, how long will it take, and does it hurt can keep us from making the appointment at all.  

I would like to reiterate the value of an annual mammogram and answer some of the common questions, so first timers can feel good about making the appointment and having the test done.

Annual mammograms are important, because they provide the greatest chance to detect breast cancer early. When we detect breast cancer early, it is more treatable. An early cancer may be treated with surgery and a series of 5-minute radiation therapy sessions. A cancer caught late could mean years of intense life-derailing treatment. Making an hour for a mammogram now could save many hours of treatment later.

First, you will need a referral from your primary care provider, OB/GYN, or certified nurse midwife. If you are a woman over 40 or someone with increased risk of breast cancer, getting a referral once a year is expected.

Once you have a referral, you call to schedule. Plan on spending 45 minutes to complete the entire appointment. The actual exam only takes about 5 minutes. When you schedule, you will be directed not to wear deodorant, powder, perfumes, creams, or ointments. It is wise to wear a two-piece outfit, as you only have to undress from the waist up. 

Once you arrive to the office, you register and change into a gown or smock that opens at the front. The technician will welcome you into the mammography room and explain the procedure. She will take two pictures of each breast, one each from the top and the side.

At SVMC, we use the latest 3D breast imaging technology. Our Hologic Selenia Dimensions Mammography System is the same equipment used at the most advanced imaging centers in the country, including John’s Hopkins and Kettering Health Network. It allows the radiologist, who will review the images, to see through many layers of tissue, which increases detection and decreases unnecessary retesting.

The technologist is an expert positioner. She will direct you to take one arm out of your sleeve and arrange you in a sort of hug of the machine. She will place your breast between two flat panels, and move the upper panel down to compress the breast. Honestly, it isn’t the most comfortable thing, but it only lasts a few seconds. The technologist will move to the control panel and direct you to hold your breath while she takes the images.

A safe, low-dose X-ray is used to take multiple images per compression. All four compressions take fewer than 90 seconds total. Even combined with repositioning and explaining things, the whole exam takes about 5 minutes. The images are read by a radiologist the next day.

Ninety percent of women hear by mail or the patient portal that there were no findings. This means that the mammogram was normal and no further imaging is needed until next year’s screening. Ten percent of women may receive a call that additional pictures are necessary. And a very small number of those may need some treatment. Usually, the earlier the detection, the easier the treatment.

I hope this information is helpful in taking this important annual step to monitor and protect your health.

Jane Wright, RT/RM, is a registered technologist and mammographer who has been performing mammograms at SVMC for about 40 years.