For women, having an annual mammogram should be as routine as a dental appointment, physical, or vision test. A screening mammogram is a very efficient exam for detecting breast cancer, even at early stages. If you are contemplating a mammogram or are planning to schedule your first one, here are some things to think about before your appointment. If you are familiar with having mammograms these may be some additional things to be aware of for your future mammograms.

Your mammogram ideally should:

1) Be performed annually

The benefits of receiving an annual screening mammogram and detecting breast cancer earlier, far out-weigh any risk involved in receiving the minimal radiation. Remember that there is radiation naturally in the environment around us at all times, and radiation from artificial sources out of our control, that are each greater than the miniscule amount of radiation received from a mammogram.

2) Be performed by a FDA approved and accredited facility

According to the Mammography Quality Standards Act, all facilities in the US must be certified by the FDA and properly accredited. A common accrediting agency is the American College of Radiology, ACR. Being accredited and certified, facilities abide by standards of care and ensure quality imaging for their patients.

3) Preferably be digital

Digital is the most current technology for screening and diagnostic mammograms used frequently today. A mammogram using any technology is better than not having one at all, but if a choice can be made, go digital. Digital images use x rays the same as traditional film mammography, but digital provides several options not available to film technology. Digital images have the ability to be manipulated by the radiologist to enhance visibility, are stored electronically, sent to other care providers electronically with ease, and are compared directly to previous digital images.

4) Include a breast exam by a trained professional

Professionals trained in breast examination perform exams immediately prior to a mammogram and increase the effectiveness of breast cancer detection. Marking suspicious findings or lumps aid the radiologist by narrowing location and providing a description of the finding. In addition to a breast exam prior to a mammogram, it is also very important to routinely conduct self breast exams at home. No one knows your breasts and how they feel on a regular basis better than you, and you should monitor any change and report suspicions to your primary care provider for further instructions.

5) Be read by a radiologist with specific mammography experience

Radiologists that have concentrated training and experience reading mammograms would generally be more sensitive to observing abnormal tissue and cancer.  In smaller locations it may not be possible to find radiologists specific to mammography, and of course all radiologists have gone through extensive schooling and training, but the more experience the better.

6) Include previous images

Unless it is your baseline (first) mammogram, having previous mammograms to compare will increase the effectiveness of detecting changes in your breast tissue over time. If you are settled in an area, consistently visit the same facility where your images and records are kept. If you change facilities, request your images and physician reports be sent to your new facility prior to your appointment.

After considering the six items above, there are a few main things to know about the actual mammogram. 

1) Your mammogram will most likely be performed by a radiologic technologist specifically trained in mammography, also known as a mammographer. Mammographers have completed radiologic technology training, earned either an Associates or Bachelors degree and passed a national registry exam for general x ray, then completed additional training and taken another national registry exam for mammography.

2) The screening mammogram will typically involve taking four images, a top-to-bottom view on each side, and a side view of each side. Depending on your body type it may be necessary to perform additional images in order to include all of your tissue. There are also certain criteria required of the images before they are submitted to a radiologist for review, and additional images may be performed in order to meet these criteria.

3) Generally your mammogram should not be painful to you. It may be uncomfortable and awkward, but should not cause pain. Compression is important in mammography, but can be obtained at a tolerable level for you. Communicate appropriately with your technologist about your comfort level and let them know if something seems painful. If do fell you are experiencing pain, it may be necessary to reschedule your exam for a time when your breasts are less tender. Where you are in your cycle and other factors may make your breasts more tender at different times.

4) With #3 being said, be open and respectful of the knowledge your technologist has obtained and be willing to accept the procedure for what it is. Remember that getting the best images possible is directly related to your cooperation during the exam. Try to be calm and relaxed. Being tense will cause more discomfort and can negatively impact the image obtained. Allow the technologist to position you in the necessary place and do your best to hold that position still.

5) Do your best to follow any instructions given by your technologist. When the technologist asks you to hold your breath before the exposure, do your best to hold it and avoid movement. Movement can be detrimental to an x ray image and reduce its diagnostic quality.

Reviewing these items, you will be more prepared for your next mammogram. Be confident that you are taking good care of yourself by receiving an annual mammogram. Encourage your female loved ones to learn more about mammograms and have your first mammogram at the appropriate age based on your family history and risk factors. Together we will detect breast cancer earlier with annual screening mammograms!

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