Preparing for Your First Mammogram: What to Expect

According to a mammographer at our local hospital, women have two common fears regarding their first mammogram. The first is a fear that the test will reveal a problem. This, understandably, is a greater fear for women who come from a family with a history of breast cancer. The second is a fear of the procedure itself, which has a reputation of being painful.

Diagnostic Imaging, a monthly news publication for physicians specializing in medical imaging, reported in their publication, About Your Screening Mammogram, that major medical associations advise women should undergo annual screening by the age of forty. Of course, for women with a history of breast cancer in their family, their physicians may recommend earlier screening.

One concern for first timers is who will be assisting in the screening. The mammographer is the trained, licensed x-ray technician who will be literally handling your breasts and operating the equipment. I've never encountered a male technician, so I asked the mammographer if it was a woman dominated industry. She told me she never heard of a man in the profession. I immediately assumed it was an industry choice; to put the patient at ease. Yet, according to the mammographer I spoke to, it had more to do with the hospital's unwillingness to open themselves up to possible liability, should a nervous patient misinterpret the handling of her breast by a male mammographer.

Normally your doctor will place an order for your mammogram with the lab. Some medical insurances will pay for annual mammograms. For those who do not have insurance or do not have the funds to pay for the test, communities often sponsor regular free or discounted testing.

On the day of your mammogram, you will not be able to wear deodorant, powder or body cream. It is advisable to schedule your test early in the day, especially in the summer. Scheduling your exam on the days in your menstrual cycle when your breasts are less tender, is also recommended. Do not wear a dress to your exam. Wear a blouse and a skirt or slacks.

Admission procedures vary from hospital to hospital or lab. At our hospital, my experience would go something like this: First I check in at the front desk, where I give them my driver's license and insurance card. Since the doctor has already sent over the request, they are expecting me. After signing a couple papers, I am sent across the hall to the x-ray lab. There I hand the x-ray office personnel the papers given to me by the front office. I am then directed to the waiting room, where I am instructed to take off my blouse and bra, and to put on a short hospital gown.

A typical mammogram waiting room will have a stack of these clean, short gowns, a dressing area, and a place to sit. Usually there are other women in the room, waiting for their testing, and wearing the short gown and their slacks or skirt. This is the reason I advise against wearing a dress. Since the gown is typically short, if you wear a dress you will be sitting in your panties, or with your dress pulled down, while the other women appear fully dressed.

The waiting room may have a television running. This isn't for your entertainment. For privacy reasons, the television is left on to make it difficult to overhear the technician asking personal questions of the patient, should the screening room be on the other side of the wall.
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When you are called into the testing room, the technician will ask you several questions. She may ask you to verify your physician's name, your address, ask you if you have any lumps in your breasts or prior breast surgery. You will want to inform her if you have implants.

Before taking the mammogram, the technician will place stickers on your nipples. Should you have any moles on your breasts, she will mark those with stickers. A basic mammogram requires 4 images. One of each breast compressed from top to bottom, and one of each breast compressed from side to side. More images may be taken if you have a lump, or if your physician requested additional angles.

The test is taken standing, with your breast placed on a shelf like area of the machine, which is adjusted in height to match the elevation of your breasts. You lean into the machine, and the technician arranges your breast, positioning it accurately. The machine compresses your breast, and you are asked to hold your breath. As in an x-ray, it takes just a few seconds for the x-ray to be taken. As soon as the image is captured, the machine automatically releases your breast from its grasp.

The procedure is uncomfortable, and for some painful. Yet, a routine test is over in a matter of minutes.

After the images are taken, you are asked to wait in the waiting room, to develop the film. Some screening centers are converting to digital, instead of film. Back in the waiting room you will not yet remove the gown and re-dress. In a few minutes the technician will let you know if you can go ahead and get dressed, and leave, or if they need to take a few more images. Your doctor will be sent the results of the testing, and the mammographer is not allowed to discuss the image results with you.

Getting a mammogram may be uncomfortable, and sometimes painful, yet once you know what to expect, the procedure is far less intimidating.