Mammography: Do's, Don'ts, Best Practices, Tips, and Estimated Duration

What is a mammogram?

            A mammogram is an X-ray of the breast that is ordered to check for early signs of breast cancer. Most of the time, a patient’s ordering physician will put in an order for a patient to have a mammogram performed. Most patients receive their first mammogram at age 40. This is called their “baseline” mammogram, which is considered their first mammogram. If a mammogram is ordered before age 40, this may be due to a patient having symptoms such as a breast lump, nipple discharge, breast pain, or other symptoms that is alarming them to have their breast looked at in further detail. If a mammogram is ordered due to the patient having symptoms, their doctor will have to order a diagnostic mammogram. If a patient is not having any symptoms and they are coming in for their routine annual check-up, the doctor will order a screening mammogram.

            I have taken mammogram images on a patient as young as 30 years old. Some patients may arrive because of a breast lump or family history of breast cancer. If a patient is younger than 30, the radiologist may recommend that the patient start with a breast ultrasound scan depending on the symptoms.

Mammography Do’s

            When you are scheduled for a mammogram, please make sure you arrive to the facility on time or early to allow for registration, check-in, to complete paperwork, etc. As a patient, you want to wear something comfortable, such as a two-piece outfit if possible (separate top and bottom clothing). You will have to change into a hospital gown or robe for the mammography technologists to be able to image your breast properly and easily. The most important thing is to remember to remove any deodorant, lotion, antiperspirants, powders, perfume, and cream from your breast or under your arm. Some of these items may have chemicals that show up on the mammogram as microcalcifications, which could be an indication of early signs of breast cancer. To avoid any confusion or the need for a breast biopsy, we ask patients to remove this from their breast and underarms with a cleaning wipe that is provided by the facility or while they are showering.

            Before the examination, you want to tell the technologist about any family history of breast cancer, personal history of breast cancer, any symptoms or concerns pertaining to your breast, pregnancy, or if you have breast implants. Although mammograms are performed on patients that have breast implants, they are performed slightly different, so we need to know ahead of time if you have breast implants to avoid compressing your breast implants. Also, make sure you bring your prior images on a CD, jump drive, or film (if this is still being made). The radiologist has to review any prior mammogram images for comparisons. If this is your first mammogram, you do not have to worry about prior images. It is up to the radiologist’s discretion if he/she would like for the mammography technologists to proceed with the mammogram exam if you do not have your prior images. Sometimes, it may be impossible to obtain prior mammogram images due to the prior facility’s location or how long ago the mammogram was taken, but always mention that you’ve had prior mammogram images taken before.

Mammography Don’ts

            Do not wear lotion, powder, deodorant, perfume, nipple piercings, or antiperspirants because this can show up as an abnormality and the radiologist will recommend for you to be called back to the facility for more images or recommend a biopsy. It is best to remove this at your home or when you shower. As a mammographer, I understand that you may have to work before your appointment or have a meeting, but we are not paying attention to your underarm odor. Our goal as technologists is to take the best images possible for the radiologist to make a diagnosis.

            Please, do not arrive to the facility late. This backs up the schedule, cause delays in other patients’ exam, and causes the technologists to rush to get back on schedule. We do not want to rush any patient’s experience because taking the images properly is critical, and some patients may have more questions than others or may take longer to perform their mammogram exam than others. Also, do not look on the internet on what to expect during your mammogram. Some patients make themselves nervous and cause anxiety thinking it is going to be extremely painful. I always tell patients that you will experience some level of discomfort, and I will keep checking with them to make sure they are doing well.

            I always demonstrate to patients how the compression will work and let them see that I have control over applying compression to the breast. Most patients think the machine automatically compresses their breast and the tech is just there to take the images, but that is not true. Try not to ask your friends or family members about how their experience was for their mammogram. I always say that every patient is different, and everyone’s pain tolerance is different.

            Do not forget your prior mammogram films/images. The radiologist may recommend that you reschedule your appointment until we obtain your prior mammogram records. The radiologist like to compare your new mammogram images to your old ones in case there was a previous biopsy site, abnormal tissue, etc.

Best Practices

            Try to relax as much as possible during your mammogram. The technologist will have you turn your body and feet into different positions to image your breast. Staying relaxed allows your breast muscles to stay relaxed, which will allow the best images to be taken. Try your best to follow the breathing instructions that the technologist will give you. The breathing instructions will reduce motion, and motion will cause blurriness on the images.

Tips

            Keep your body relaxed during the mammogram and follow the instructions the best way you can.

Estimated Duration

            A mammogram normally takes anywhere from 5-10 minutes to perform if the patient is there for their annual mammogram. If the patient has breast implants, this may take close to 15 minutes to perform or a little less. More images are taken for patients with breast implants because some images have to be taken without the breast implants and the images that are taken with the breast implants “are not being squeezed.” If a patient is in the facility for a diagnostic mammogram, this can take anywhere from 15-30 minutes to perform and get their results back same day. If a patient is in a wheelchair or uses a walker, this may take longer to perform to ensure the mammographer is getting the best images possible, while making sure the patient does not fall.

Conclusion

            Mammograms are routinely performed annually to screen for breast cancers. Speak with your doctor to see if you are at the recommended age to have your mammograms. Do not wear deodorant, lotion, or powders because this can make your mammogram results abnormal. Please make sure you arrive to the facility on time to fill out your paperwork and prevent further delays. Always keep your prior mammogram images in a safe place in case you have to change to another facility. Relax, the mammogram is not as bad as what you think.

Post written by: Myrian Barbin, BSRS, R.T. (R)(CT)(MR)(M)(BS)(ARRT)