A mammogram is an X-ray that is used to look for breast cancer. It can be used as a screening tool for breast cancer or as a diagnostic tool to examine breast tissue.

This article will look at how mammograms are done, how they differ from diagnostic mammograms, and what to expect at your next checkup.

A mammogram is a type of X-ray used to examine breast tissue for cancers and other irregularities. Similar to a regular X-ray used to look at the structures inside your body, a mammogram uses waves of radiation to produce an image of what’s inside your body.

“You won’t be allowed to stand in front of the machine or have a pass over you during a mammogram. The mammogram machine uses two plates to compress breast tissue. The thinner examination area allows the technicians to take a lower dose of radiation than a traditional X-ray.”

Screening mammograms take a view of your breast tissue from different angles.

How often are screening mammograms done?

Screening mammograms are done intermittently, even if you don’t notice any lumps or pain. Early detection of breast cancer is important, and these scans can detect breast changes that could be concerning early — before you have any symptoms.

Mammograms are recommended at certain intervals for all women once they reach a particular age range. The U.S. Preventive Services Task Force (USPSTF) recommends the following screening intervals:

  • Women between the ages of 50 and 74 should have mammograms.
  • Women between the ages of 40 and 49 should discuss their risk levels with their doctor.

Mammography screening can be dangerous and beneficial before the age of 50. If you have a family history of breast cancer, you may need to start screening earlier.

What are 3D mammograms?

A 3D mammogram, also called breast tomosynthesis or digital breast tomosynthesis, is very similar to a 2D mammogram.

The machine revolves around your breast to give a more complete view of the tissue. Your doctor can see this image in slices, which are separated by tiny sections of breast tissue.

Studies are now looking into whether these scans are preferable to 2D scans for everyone. So far, it appears that 3D scans reduce the need for additional follow-up testing after 2D scans. They can also be helpful in locating more cancerous areas — especially in people with dense breast tissue.

Diagnostic mammograms and screening mammograms are very similar in how they are performed and the results they produce. The main differences are how often they are done and why.

  • “A screening mammogram is a screening tool that can find breast cancer in people who aren’t experiencing any symptoms.”
  • A mammogram is done after a lump is found in the breast.
  • Your doctor will look at the entire breast during the screenings. They may spend more time with a diagnostic mammogram than with a screening mammogram.

The benefits of mammograms are few but significant. The primary benefit of a mammogram is the early detection of breast cancer. Regular screening mammograms are good at finding early stage cancers. According to a 2020 study, this results in about a 20 percent reduction in breast cancer deaths.

No test is perfect, but early detection is critical to treatment and overcoming breast cancer.

One major risk of breast cancer screening mammograms is a false positive result that can lead to anxiety and over-testing. Mammograms can also miss about 20 to 30 percent of cancers, according to a 2020 study.

Studies show that timing is an important factor in breast cancer. Interval breast cancers are caused by one screening but before the next.

The same study found interval breast cancer.

Concern about radiation exposure

Many people choose to delay or extend mammogram screenings. There is concern about radiation exposure during a mammogram.

According to the American Cancer Society, the benefits of screening mammograms outweigh the risk, especially considering the low level of radiation exposure.

The typical radiation dose with a two-view mammogram is roughly 0.4 millisieverts. A 3D mammogram can be slightly above or below this level.

In comparison, people in the United States receive about 3 millisieverts of radiation every year just from their natural surroundings. This means that the radiation you are exposed to during a mammogram is about equal to the amount of radiation you are exposed to anywhere else over about 7 weeks.

“If you are pregnant, the risk consideration is slightly different. Mammograms are usually safe during pregnancy and the radiation risk to a developing fetus is small. If you don’t have a heightened risk of breast cancer, you may skip routine screenings.”

You can get a mammogram at a hospital. A primary care doctor or gynecologist can help you arrange for breast cancer screening. Some facilities offer mammogram screenings.

The Food and Drug Administration (FDA) has also created a national directory of facilities that perform mammograms. You can search the directory by state or zip code.

It should take you less than an hour to get a mammogram. You will be taken to an examination area where you will be asked to remove your clothing. It can be helpful to wear shirts that are easy to remove. The facility will provide a gown or cover for your mammogram.

You may be asked to not wear any of the items during your mammogram. These can make it difficult for the machine to get your breast tissue compressed, and may cause white spots on the final pictures.

The mammogram itself won’t take long, but the exact time depends on the individual. You should be able to complete your entire appointment in about 30 minutes.

Some people find the scan itself painful due to awkward positioning and the pressure of the two plates on your breast tissue. But this pressure is applied for only a few seconds at a time.

“You will be able to leave your appointment when the scans are complete. Don’t expect your results to happen right away. It can take a few days to get a final report from the facility.”

Timing is everything

Timing can affect your mammogram results. Your breasts may be swollen or heavy the week before your menstrual cycle. It is best to schedule your appointment with this in mind.

You may also want to consider the timing of a COVID-19 vaccination. Radiologists have noticed some changes in mammograms after COVID-19 vaccination, specifically with the swelling or enlargement of lymph nodes around the breasts.

However, a 2022 study suggests that technicians and doctors are taking vaccination status and timing into consideration when analyzing mammograms. The study authors say there is no need to delay your mammogram because of a COVID-19 vaccination.

Medicare and Medicaid both cover the cost of mammograms, and all private insurance plans have had to include coverage for this test since the passage of the Affordable Care Act in 2010.

In 2019, Susan G. Komen published a report on the cost of breast imaging tests throughout the United States. The report found that the cost of a mammogram varies by state, with screening mammograms ranging between about $65 and $380 for people without insurance as of 2019.

Diagnostic mammograms cost more, with the price tag reaching over $1,000 in some areas.

If you can’t afford a mammogram, there are programs that can help

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) helps people with low incomes or without insurance receive breast and cervical cancer screenings and diagnostic testing.

If you are eligible for free or low cost screenings, you can get them.

  • “You don’t have insurance.”
  • “Your insurance won’t cover your screening.”
  • Your income is at or below the poverty level.
  • You need to have your breast cancer screening when you are between the ages of 40 and 64.
  • You should be screened for cancer at the age of 21 and 64.
  • You have an increased risk of these cancers if you are outside of these age ranges.

You can search for testing information and locations by state on the website of the Centers for Disease Control and Prevention (CDC).

Are mammograms the best way to detect breast cancer?

Even if you are not having any symptoms, mammograms can detect breast cancer if it is present. This can lead to a better outcome.

Mammography is the best way to provide regular screenings in a non-intimidating way.

What other screening methods are used for breast cancer?

If you have atypical mammogram results or are having symptoms, your doctor may want to perform more detailed tests to confirm a cancer diagnosis. These can include:

Can you have a mammogram if you have breast implants?

Even if you have breast implants, you should still get mammograms. You should tell your technician that you have implants, as you may need more images taken during the scans.

“Tissue analysis can be more difficult with certain types of implants. If you have a double mastectomy, you don’t need to be screened with implants.”

Do you need mammogram screening after a double mastectomy?

“There is not enough natural tissue left on your breasts to test for breast cancer after a double mastectomy. A mammogram won’t be one of the follow-up screenings after a breast cancer diagnosis.”

If you only had one breast removed, the exception is possible.

Should men get mammograms?

Typically, there’s not enough breast tissue on a person assigned male at birth to perform a standard mammogram. According to Johns Hopkins Medicine, only about 1 percent of all breast cancers develop in men.

However, some people may still need to be screened. For example, people who have certain genetic mutations or other risk factors should be screened for both breast and prostate cancers, regardless of the gender they were assigned at birth. Make this decision with the help of a doctor, based on your individual risk.