The American College of Radiology and Society of Breast Imaging recommend that women of average risk start getting annual mammograms at age 40. Yet, a little over 66% of women in that age group report having done so in recent years, according to the Centers for Disease Control and Prevention.

There can be a plethora of reasons why you’re putting off your annual mammogram; maybe you’re worried it will be painful or awkward; maybe you’re worried about the potential cost; maybe you’re super busy and can’t find time; maybe you have no family history of breast cancer, or maybe you think you’re too young. Whatever your reasoning is, receiving your annual mammogram, even if you are of average risk, is an important prevention measure with the goal of catching any suspicious lumps or masses early.

That’s why we spoke with Jackie Mitchusson, a registered radiologic technologist on the staff at Texas Health Breast Care at Texas Health Dallas to answer all your questions regarding your first mammogram and what the experience will be like.

Preparing For the Screening

Mitchusson advises scheduling your mammogram when your breasts aren’t likely to be tender or swollen to help reduce discomfort.

If you’re pre-menopausal, you’re most likely to be tender the week before and the week during your menstrual cycle.

“For those who are menopausal or post-menopausal, you’ll most likely know when those fluctuations are and when the best time to come in is for you,” Mitchusson adds.

You are also not allowed to wear deodorant, antiperspirants, powders, lotions, glitters, bronzers, creams or perfumes under your arms or on or around your breasts prior to the procedure because elements in these items, especially metallic elements, can pick up on the imaging and may look like a potential problem area that will require additional imaging.

If your appointment is later in the day or you’ve forgotten, Mitchusson says most imaging centers will have wipes or towelettes for removal.

Also, some imaging centers require your doctor’s information prior to scheduling, but if you haven’t already provided it, make sure to have the name, address and phone number of the health care provider who ordered the mammogram so that the imaging center can send the images and report to them afterward.

You may want to wear an outfit in which you only have to remove your top versus wearing a dress, romper or bodysuit that would require you to fully undress. Regardless, the technologist will provide you with a gown.

During the Exam

During the mammogram, you and a trained technologist will be the only ones in the exam room. The tech will position your breasts one at a time between a mammography paddle and the image receptor plates. The mammography paddle will gently apply compression while taking X-ray images. Multiple images will be taken from multiple positions. The exam itself may take anywhere between 10 and 15 minutes as the technologist positions you and examines the quality of each image to ensure a good read, but your breasts will be compressed for a matter of seconds each time an image is taken. 

“It can be uncomfortable. We do need to apply pressure to really spread that breast tissue out and hold it in place for the images,” Mitchusson explains. “What I typically do is ask the patient after the first image how they’re doing. We usually take four to six pictures in total. If they report back that there’s some pain there, we work with them. If you know you have sensitive breasts, just let your tech know and they can work with you.”

It usually takes 24-48 hours to get your results back, but it can be sooner than that.

“If you’re a Texas Health Resources patient and you’re set up on MyChart, those results will actually go straight to your MyChart as soon as possible,” Mitchusson adds. “Your doctor will get a copy of the report, you’ll receive them in your MyChart and then you’ll also receive your results in the mail.”

Unusual Findings Can Be Common

If there are any abnormal results or inconclusive results, a nurse will give you a call and let you know that you need to come back in for additional imaging — but don’t panic — unusual findings can be common, especially if this is your first mammogram.

“We’ve never seen you before and we don’t know what is normal or abnormal for you. As you continue getting mammograms, the imaging center and your doctor will compare your new images to the ones you had the year before and the year before that, etc. to look for any changes,” Mitchusson explains. “But when it’s your first mammogram, we don’t have anything to compare it too, so something may flag that’s completely normal. Typically, it’s nothing to worry about but we like to play it safe. I tell people all the time if you get called back, especially after your first or first few mammograms, don’t panic, don’t expect the worst.”

Common Concerns

With 20 years of experience, Mitchusson says she’s heard “everything” regarding why someone has put off a mammogram.

“Of course, I hear people worried about how painful it is,” she says. “They hear these horror stories from friends or family or coworkers about how horribly painful it is. Or they know their breasts are sensitive or dense. And of course, no one wants to volunteer to do something painful. But I would say more patients describe the feeling as ‘uncomfortable’ or ‘weird,’ not painful. Honestly, I would say 99.9% of patients will say it wasn’t bad at all; that they got led to believe it was way worse than it really was.”

The best advice Mitchusson has? Relax as much as you can.

“Anxiety about the exam is a big contributing factor to pain during the exam. People tend to tense up because they’re nervous and therefore it may be a bit difficult to get you in the appropriate position and that can be more painful. I like for patients to get in there and be relaxed and I do my best to walk them through it so they know what’s happening step by step to help alleviate those nerves.”

One of the more troubling reasons Mitchusson says she hears is putting off your mammogram because you don’t have a family history of breast cancer. 

“I don’t want to scare anyone, but we get a lot of women who are getting diagnosed with breast cancer who have zero family history,” she says. “Yes, there is a genetic component to breast cancer, but don’t think you’re out of the woods because you don’t have a family history. We’ve all lived life; we’ve all been exposed to numerous things in or out of our control — family history is just one contributing factor.”

Above all else, Mitchusson says one of the biggest deterrents is the fear of finding something.

“Of course, no one wants to hear the words, ‘you have cancer,’ but we can catch things so early now with 3D imaging, that if we do find something, you’re going to have more treatment options, and oftentimes less invasive treatment options the sooner you catch something versus letting it go and finding something at a more advanced stage,” she explains. “If you have a mass, it’s going to be there whether you get screened or not. But if we find it early, it can really make a world of difference when it comes to treatment.”

Mammograms Save Lives

No matter your fears or concerns, Mitchusson says there’s no excuse too good to put off your mammogram, and she feels there’s no better time to get a mammogram than now thanks to advancements in technology and care.

“This isn’t your grandma’s mammogram,” she says with a laugh. “Honestly, it’s almost not even your mother’s mammogram anymore, that’s how far we’ve come. They’re more comfortable than ever before, the technology is better, and we have so much research and information now.

“Actually, I feel like in the last 15 years I’ve seen an increase in women making a point to get their mammograms. Women are talking about it and there’s less of a taboo revolving around women’s health care and breast care. Women now are coming in and they’re more educated about the topic, and they’re advocating for their health unlike generations before.”

Cost or access to care should never be a deterrent. Many organizations in North Texas help with free or low-cost mammography.

“And we’re meeting you where you are now. Texas Health offers Mobile Health Screening Mammograms that goes to locations throughout the Dallas – Fort Worth community for women who either can’t afford a mammogram or they can’t get time off work to come in,” Mitchusson adds. “Everyone deserves access to care, but especially lifesaving care like this.” 

To schedule a mammogram at a Texas Health facility, visit TexasHealth.org/BreastCare. Early morning, evening and Saturday appointments available at most locations.