Screening Mammograms: When to Start, How Often and How to Prepare

Screening and diagnostic mammograms

There are two main reasons to get a mammogram.

• Screening mammogram. This is a routine test for people who have no breast symptoms. The goal is to find cancer early, when it is often easier to treat.
• Diagnostic mammogram. This is used when there is a symptom or a change, such as a lump, or when a screening mammogram shows an area that needs a closer look. It may include extra images or an ultrasound.

If you notice a new lump, skin changes, nipple discharge or another change in your breast, do not wait for your next screening. Call your provider to talk about it.

When to start and how often

The U.S. Preventive Services Task Force (USPSTF) recommends a screening mammogram every two years for women ages 40 to 74 at average risk of breast cancer. Some people choose to be screened every year. Talk with your provider about which schedule fits you.

For women 75 and older, there is not enough evidence to make a general recommendation. The decision depends on your overall health and preferences, so it is best made with your provider.

If you have a higher risk

Some people may need to start earlier or have other tests. Talk with your provider if you have:

• A mother, sister or daughter who had breast cancer, especially at a young age
• A known gene change linked to breast cancer, such as BRCA1 or BRCA2, or a close relative with one
• Past radiation therapy to the chest
• A past breast biopsy with certain abnormal findings

Your provider can review your history and help you decide when to start and which tests make sense.

What 3D mammography is

A standard mammogram takes flat, two-dimensional pictures of each breast. A 3D mammogram, also called breast tomosynthesis, takes many pictures from different angles. A computer puts these together into thin layers. This lets the radiologist look through the breast tissue layer by layer, which can make some areas easier to see. Our clinic in The Woodlands offers 3D mammography.

Dense breast tissue

Breast tissue that has more glandular and fibrous tissue than fat is called dense. Dense tissue is common and normal. It can make some cancers harder to see on a mammogram. Your mammogram report will say if you have dense breasts. If it does, ask your provider whether any additional imaging, such as a breast ultrasound, is right for you.

How to prepare

• Wear a two-piece outfit so you only need to remove your top.
• On the day of your exam, do not use deodorant, powder or lotion on your chest or underarms. These can show up on the images.
• If your breasts are tender before your period, you may want to schedule your mammogram for a time when they are less sore.
• Tell the technologist if you have breast implants, are pregnant or might be pregnant, or are breastfeeding.

What to bring

• A government-issued photo ID
• Your referral or order form, if you have one
• A disc with your last mammogram images, if you had them done somewhere else
• A written list of any symptoms or concerns
• Your insurance card

Past images help the radiologist compare and see whether anything has changed.

What happens during the exam

You will undress from the waist up and wear a gown. A technologist places one breast at a time on the machine. A clear plate presses down on the breast for a few seconds while the pictures are taken. Pressing the breast flat helps make the images clear and lowers the amount of radiation needed. Many people feel pressure, and some feel brief discomfort. Tell the technologist if it hurts. The process is repeated from different angles and then on the other breast.

After your mammogram

A radiologist reviews your images, and our team contacts you to discuss findings and next steps. Sometimes you may be asked to come back for more pictures or an ultrasound. This is common and does not mean you have cancer. Often it means an area needs a clearer view.

Mammograms for Katy patients

Mammography and ultrasound are offered only at our clinic in The Woodlands, at 25511 Budde Rd, Suite 3901. Patients who usually see a provider at our Katy clinic come to The Woodlands for these exams.

How to schedule

To book a mammogram, use the Book Appointment button at the top of this page, call (281) 466-4644, use the Book Now button in the site menu or chat with our bilingual assistant. Our staff speaks English and Spanish. Learn more on our mammogram and ultrasound page, or read about cervical cancer screening and well woman care. For accepted plans, see our insurance page.