The Ultimate Guide to Mammograms

According to the National Cancer Institute, breast cancer is the second most common type of cancer affecting women after skin cancer. With around 290,000 new cases of breast cancer diagnosed each year, it accounts for about 30% of all cancers diagnosed in women. About 43,000 women die from breast cancer every year.

While these figures may sound grim, there is still plenty of hope. Around 90% of all women diagnosed with breast cancer are likely to survive longer than 5 years. But it is important to note that the chances of survival largely depend on the early detection of cancer.

A proven and reliable way to identify the presence of breast cancer is by taking a mammogram. In this blog post, you will learn everything you need to know about mammograms, including:

• What are mammograms?
• Why are mammograms important?
• Who should take a mammogram?
• How to prepare for a mammogram?

What Is a Mammogram?

A mammogram is an x-ray image of your breast. It is taken using an x-ray machine designed to focus on the breast tissue. Since these images are only limited to a small part of your body, the diagnostic machines use lower dose x-rays than regular equipment. The technique of using x-rays on breasts is called mammography.

The main purpose of a mammogram is to check for breast cancers. Mammography is quite reliable at finding early signs of cancer in your breast. Mammograms are much more effective at this than a breast self-exam where you use your hands to check for lumps in the breast. With that said, it does not undermine the importance of women being familiar with their breasts, which often leads women to seek a mammogram on the suspicion of an abnormality in the external breast tissue.

There are generally two types of mammograms:

• Screening mammograms
• Diagnostic mammograms

What Are Screening Mammograms?

Screening mammograms are short procedures that only take around 10–15 minutes. A screening mammogram is done on a woman who has no signs or symptoms of breast cancer. The purpose of a screening mammogram is to look for hidden signs of cancer deep inside the breast tissue.

Doctors usually recommend screening mammograms for women of certain age groups. They are also recommended to young women if they have a family history, genetic conditions, or any other reason for higher cancer risk. Such mammograms are taken annually, or at regular intervals like 1–2 years to diagnose breast disease.

In a screening mammogram, a specially trained doctor (a radiologist) will check the breast imaging after it is taken. They will then submit a report with their findings to your doctor. Screening mammograms are covered by private insurance plans and Medicaid for women above the age of 40.  The Illinois Breast and Cervical Cancer Program offers free mammograms, breast exams, pelvic exams, and Pap tests to eligible women. Even if a woman has already been diagnosed with cancer, she may receive free treatment if she qualifies. The program has been providing breast and cervical cancer screenings to the women of Illinois since 1995. VNA’s Women’s Health team will assist with registration for this program if eligible.

What Are Diagnostic Mammograms?

If a woman’s screening mammogram shows any signs of cancer, the doctor will order a diagnostic mammogram as a follow-up procedure. Diagnostic mammograms are also prescribed for women who are showing other symptoms like lumps, pain in the breast, changes in shape, etc.

Diagnostic mammograms are usually taken in the presence of a radiologist. They will check the results immediately and decide if further tests are needed. If there are clear abnormalities in the breast, the radiologist will order additional scans and ultrasounds of the affected breast.

What Happens During a Mammogram?

Many women want to know how is mammogram done. At first, the healthcare provider at the mammography facility will ask about your family history. They will also ask if you have had a mammogram in the past. After this, you will be taken to a waiting room. A mammogram is taken in a special room used exclusively for women undergoing this process.

Once you enter the mammogram room, you will have to undress from the waist upwards for this procedure. You will be given a gown for privacy.  The nurse or x-ray technologist may place some stickers on some parts of your breast. If you have any skin marks or birthmarks on your breast, they may show up on a mammogram. The stickers help prevent any confusion when the technologist or radiologist is looking at the image. Sometimes, the nurse may also place stickers on your nipples to mark their position on the mammogram. This helps the medical imaging specialists during the mammogram.

Finally, the technician will ask you to stand in front of the x-ray machine. The x-ray machine will have a special plate-like surface – the nurse/technician will place your breast on this surface. Only one breast is placed at a time on the machine.

To hold your breast still for the scan, another plate will press down on your breast from above. You may feel some pressure and discomfort at this point as the two plastic plates flatten your breast. This is important for more accurate detection of any abnormal tissues inside the breast.

The machine will take x-ray images of your breast from several angles to get a complete picture. Typically, each mammogram is made up of two x-rays, one taken from the sides and another from the top/front.

The process is repeated for both your breasts. The x-rays are taken relatively quickly and the whole process should not take more than 10–15 minutes maximum. The technician will check the images to ensure that they have been taken properly.

The results are then sent to a radiologist, a doctor who specializes in medical imaging and scans. The radiologist will evaluate your mammogram and send the results to your doctor. You can expect to receive your mammogram results a few weeks after the procedure.

Are Mammograms Painful or Uncomfortable?

In general, some women may find mammograms somewhat uncomfortable. The plates pressing down on the breast can feel awkward and a bit unpleasant, even if it is only for a few minutes. A skilled and compassionate nurse/technician can help reduce the general feeling of uneasiness.

In exceptional cases, a woman may experience pain during a mammogram. This is often due to one of the following factors:

• The size and shape of the breasts.
• How firmly they need to be pressed.
• Menstruation – breasts are often more sensitive during periods.
• If mammography is done after breast surgery or breast biopsy.

It is entirely normal to experience at least some discomfort from a mammogram. The level of discomfort/pain will vary widely though. Some women feel nothing at all. Some feel slight pain and have minor bruising on the breast – which might happen more in patients who are taking any blood-thinning medication.

Unlike other medical procedures, like biopsies, a mammogram is generally painless. You don’t experience any continued pain or discomfort once the procedure is completed.

How to Prepare for a Mammogram?

There are several things that you can do to reduce the level of discomfort and improve the chances of a quick and successful mammogram procedure. They include the following:

• Avoid scheduling your visit when you are close to your period to reduce the chance of breast tenderness and pain.
• Wear separate clothing pieces – this way, you don’t have to remove your entire outfit for the mammogram.
• Avoid using deodorants, perfumes, or powder on the day of the mammogram as they can show up as white spots on the x-ray image.
• Inform the staff if you have any breast implants – they may need more x-rays for a better picture.
• Taking an over-the-counter medication like aspirin or acetaminophen can reduce the risk of pain (consult your health care provider before doing this).

Why Are Mammograms So Important?

Doctors have been using mammograms to diagnose breast cancer in women for several decades now. They have yet to discover a better, simpler, or safer way to find signs of breast cancer sooner than mammograms.

Early detection of breast cancer is very important to improve your chances of survival. Other techniques like checking your breast for lumps with your fingers will only find cancer once it has developed to a larger stage.

With a mammogram, you can often detect cancer three years before it reaches the stage where lumps form. The longer you allow cancer to spread undetected can lower your chances of survival by a huge factor.

After some time, cancer will spread from its original starting point to other organs and parts of the body. Once this happens, the disease becomes harder to cure. Here is a quick look at the 5-year survival rate for breast cancers at different stages:

• Localized – cancer has not spread outside the breast – 99% survival rate.
• Regional – cancer has spread to nearby areas or lymph nodes – 86% survival rate.
• Distant – cancer has spread to lungs, liver, and other organs – 29% survival rate.

It is quite clear that with an early-stage breast cancer diagnosis, you have a much better chance of surviving for 5 years or more. This is why mammograms are so important – if healthcare providers can find breast cancer early, they can help save lives.

Who Should Get Regular (Annual) Mammograms?

According to the guidelines issued by the American Cancer Society:

• Women in the age group of 40–44 may choose to undergo an annual mammogram if they want periodic breast cancer screening.
• Women in the age group of 45–54 are recommended to have their mammograms done every year.
• Women in the age group of 55 and above may either continue annual screening or undergo mammograms once every two years.
• All women should be aware of the recognized benefits and limitations of breast cancer screening.

Annual mammograms are particularly recommended for women who are at a higher risk of getting breast cancer or have a known family history of this disease. The majority of breast cancers are detected in women who are above the age of 50. Relatively few women under the age of 45 get breast cancer. This is why doctors usually keep 40 as the minimum age when you need to start getting regular screening mammograms.

However, this is not a fixed guideline. Your risk of getting cancer can depend on many other factors as well. Your healthcare provider will evaluate all these factors and decide on the importance of annual mammograms.

Here are some common factors other than old age that put women at an increased risk of breast cancer:

• Genetics – Some women inherit specific genes from their parents, called BRCA1 and BRCA2, and are at higher risk of breast tissue and ovarian cancer.
• Family History – If other women in your immediate family have a history of breast cancer, you may be at a higher risk.
• Menstruation – If you had your first period before the age of 12 or started menopause after 55, your body is at a higher risk of breast cancer due to longer exposure to hormones.
• Ethnicity/Race – Black women are more at risk of developing breast cancer than women of other ethnicities. They are also at higher risk of developing breast cancer before the age of 45.
• Medical History – Exposure to certain drugs or radiation for the treatment of other cancers early in life can put you at higher risk of breast cancer.

Doctors may also consider other factors like obesity, hormone therapy, getting pregnant after 30, and alcohol/tobacco/drug use before deciding your level of risk for breast cancer. If you are at higher risk, the doctors may prescribe early annual screening mammograms.

Are There Any Side Effects or Risks From Mammograms?

One primary risk that many people worry about with any type of x-ray is exposure to radiation. But the radiation risk from mammograms is fairly insignificant when compared to other types of x-rays.

One of the challenges for women is the anxiety that undergoing a mammogram may create. Some women may want to avoid going through this experience of anxiety and decide not to go for annual mammograms. This is putting yourself at unnecessary risk – the minor extra anxiety is well worth the chance of saving your life. Furthermore, once you have had a mammogram, you will know how safe, quick, and painless the experience is, and it will give you the confidence to have regular screenings in the future.

Mammogram Costs and Insurance Coverage

According to the Affordable Care Act (ACA), screening mammograms have insurance coverage under Medicare, Medicaid, and private health insurance plans. For eligible women, the insurance provider will pay for 100% of the cost of a screening mammogram and you will not have to pay anything. But the eligibility age and the number of free screenings can vary depending on the program and healthcare provider. Here are some examples:

Medicaid

Women between 20 and 39 will get one paid mammogram screening test if they are in a high-risk category for breast tissue cancer. For other women, it is one mammogram between the ages 35–39 and free yearly mammograms after the age of 40.

Private/Market Plans

For private plans, most insurance companies offer free annual mammograms for women over the age of 40. Many companies may also offer free annual screenings for women above 30 if they are in high-risk groups.

Diagnostic mammograms are not covered by Medicare, Medicaid, and virtually all private insurance plans. Without insurance, a diagnostic mammogram can cost above $280. In contrast, screening mammograms are less expensive, costing between $100 to $250.

Mammograms Without Insurance Coverage

There are several government programs that provide free or low-cost screening mammograms to women who are uninsured or lack full coverage. The Center for Disease Control (CDC) runs a program for free mammograms under National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

Many local programs receive funding from the NBCCEDP. In Illinois, the Illinois Breast and Cervical Cancer Program (IBCCP) provides free mammograms to women with the following qualifications:

• Illinois residents
• Have no insurance coverage
• Between the ages 35 and 64

Other national cancer organizations like the American Breast Cancer Foundation and National Breast Cancer Foundation all have special programs for mammogram financial assistance for women from low-income groups.

You might also be eligible for free or low-cost mammograms from state Medicaid even if you are not already enrolled.  VNA’s Women’s Health team will help determine your eligibility and will assist with registration if applicable.

Contact VNA Health Care to Schedule a Free/Low-Cost Mammogram

VNA Health Care is a not-for-profit organization providing high-quality, affordable health care services to communities in suburban Chicagoland and other outlying areas in Illinois. We are the leading agency for free mammograms under the IBCCP in DuPage, Kane, Kendall, Kankakee, and Will counties. If you are above the age of 40 or in the high-risk category for breast cancer, make an appointment for a screening mammogram at VNA Health Care today.

To learn more about mammograms, visit our website.

Funding provided in whole or in part by the Illinois Breast and Cervical Cancer Program