A mammogram is a special type of X-ray that’s used to scan breast tissue. It may be used as either a screening tool for breast cancer or a diagnostic tool to examine unusual breast tissue.

This article will explore how and why screening 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.

During a mammogram, you won’t stand in front of an X-ray machine or have one pass over you. Instead, a mammogram machine uses two plates to compress breast tissue during the scan. This makes the examination area thinner and allows the technicians to capture an image with lower doses of radiation than a traditional X-ray.

Screening mammograms usually take a view of your breast tissue from at least two 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 a screening mammogram every 2 years.
  • Women between the ages of 40 and 49 should discuss their personal risk level and screening frequency with a doctor.

There are risks and benefits to having screening mammograms for breast cancer, especially before the age of 50. If you have certain genetic mutations in your family or other risk factors for early onset breast cancer, you may need to start screenings earlier.

What are 3D mammograms?

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

However, instead of capturing images from two stationary angles, the machine revolves around your breast to provide a more complete view of the tissue. Your doctor is then able to view this image in “slices,” separating tiny sections of breast tissue for a closer look.

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.

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Screening mammograms and diagnostic mammograms are very similar in the way they’re performed and the results they produce. The main differences are why and how often they are done.

  • A screening mammogram is what it implies: a screening tool to find cases of breast cancer in people who aren’t experiencing any symptoms.
  • A diagnostic mammogram is done after the discovery of a lump in the breast or other symptoms.
  • During both screenings, your doctor will examine the entire breast. But they may spend extra time and capture more images 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.

Early detection is critical to treating and overcoming breast cancer, but no test is perfect.

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 also show that timing is an important factor, with some people developing breast cancer in between screenings. These cancers, called interval breast cancers, develop after one screening but before the next.

The same 2020 study found that interval breast cancers were detected in:

Concern about radiation exposure

People may choose to delay or extend the intervals of their mammogram screenings for many reasons. One of these reasons is concern about radiation exposure during a mammogram scan.

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.

The consideration of this risk changes slightly if you are pregnant. The radiation risk to a developing fetus is small, and mammograms are usually considered safe during pregnancy. But you may skip routine screenings out of caution if you don’t have a heightened risk of developing breast cancer.

You can get a mammogram at a hospital, specialty clinic, or doctor’s office. A primary care doctor or gynecologist can discuss breast cancer screening with you and help you set up an appointment. Some facilities even offer walk-in 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.

Getting a mammogram shouldn’t take you more than 1 hour. Once you check in for your appointment, you will be guided to an examination area, where you will be asked to remove your clothing above your waist. It can help to wear shirts that are easy to remove and put back on. The facility will provide some type of cover or gown for your mammogram.

You may also be asked ahead of time to not wear any deodorants, perfumes, lotions, or powders during your mammogram. These can make it difficult for the machine to compress your breast tissue, and may show up as 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.

When the scan is complete, you will be able to get dressed and leave your appointment. Don’t expect your results right away. Depending on the facility, it can take you a few days to several weeks to receive a final report.

Timing is everything

How often you have a mammogram isn’t the only way timing can affect your results. Your breasts may be particularly heavy or swollen the week before or during your menstrual cycle. It’s 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.

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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.

You are eligible for free or low cost screenings and diagnostic testing if:

  • You have no insurance.
  • Your insurance does not cover your screening.
  • Your income is at or below 250 percent of the federal poverty level.
  • You are between the ages of 40 and 64 and need breast cancer screening.
  • You are between the ages of 21 and 64 and need cervical cancer screening.
  • You fall outside of these age ranges but have an increased risk of these cancers.

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

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Are mammograms the best way to detect breast cancer?

Mammograms can detect tissue that raises concern for breast cancer, even if you are not having any symptoms. This can lead to early diagnosis of breast cancer and a better outcome.

While the accuracy of mammograms isn’t perfect, they are currently the best way to provide regular screenings in a noninvasive way.

What other screening methods are used for breast cancer?

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

Can you have a mammogram if you have breast implants?

You can — and should — continue to get regular mammograms even if you have breast implants. Be sure to tell your technician that you have implants, as you may need a few more images captured during the scan.

Certain types of implants can make tissue analysis more challenging. The only time you don’t need to be screened with implants is if they were placed after a complete double mastectomy.

Do you need mammogram screening after a double mastectomy?

After a double mastectomy, there’s likely very little natural tissue left on your breasts — and certainly not enough to test with a mammogram. You may have other follow-up screenings after a breast cancer diagnosis and mastectomy, but a mammogram won’t be one of them.

The exception is if you had only a single breast removed.

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.