Why Do I Need a Mammogram?

Clinical Contributor to this blog:

Jessica Yao, M.D.
Chief Medical Officer

Mammograms save lives! Early detection plus starting treatment earlier equals a higher breast cancer survival rate. A mammogram is an X-ray picture of the breast. Doctors use a mammogram to look for early signs of breast cancer. They are considered the best way to detect breast cancer early.

There are two types of mammograms: screening and diagnostic. A screening mammogram is the standard test recommended for women at average risk, usually beginning at age 40. But if you are experiencing breast changes, such as a lump, pain, nipple discharge, change in breast size or shape, or you’ve had breast cancer before, you’ll need a diagnostic mammogram. Also, if a screening mammogram shows an abnormality, your doctor may order additional imaging, like a diagnostic mammogram or breast ultrasound.

When Do Women Need to Start Getting Mammograms?

Most women should start getting an annual mammogram when they turn 40, according to the American College of Obstetricians and Gynecologists. According to the National Breast Cancer Foundation, 1 in every 8 women will have breast cancer in her lifetime. Breast cancer is the second most common type of cancer in women after skin cancer.

Some women and men may need to start mammography screenings earlier than age 40. Your primary care provider (PCP), gynecologist, or oncologist may refer you for a mammogram earlier if you have these risk factors:

If you have had breast cancer before.
If you have a family history of breast cancer.
If you or your doctor discover a lump in your breast or other questionable changes in breast tissue.
If you test positive for BRCA and/or other genetic mutations that increase your likelihood of getting breast cancer.
If you have dense breasts or certain benign (non-cancerous) breast conditions.

Mammograms Improve Breast Cancer Survival Rates

Along with regular breast self-awareness and yearly clinical breast exams (often part of a woman’s wellness visit or annual health exam), mammograms have helped save hundreds of thousands of women’s lives. According to the American Cancer Society, when breast cancer is detected early and is in the localized stage, the five-year relative survival rate is 99% and 91% for all stages combined.

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Breastcancer.org reports that “Women diagnosed with breast cancer who had regular mammograms had a 60% lower risk of dying from the disease in the 10 years after diagnosis and a 47% lower risk of dying from the disease in the 20 years after diagnosis compared to women who didn’t have regular screenings.”

The improved survival rates from early detection make it clear that mammograms are one of the most powerful tools we have to fight breast cancer.

Even with advances in treatment, the American Cancer Society reports that more than 270,000 women were diagnosed with breast cancer, and more than 43,000 women in the United States died from breast cancer in 2023. At the same time, there are more than 4 million breast cancer survivors in the U.S. today. This shows how important it is to have a mammogram.

While mammograms are the best way to detect breast cancer in the early stages, even before you or your doctor notices any changes in the breast tissue, it is also important to stay breast aware, know what is normal, report any changes in a timely manner, and schedule your annual well-woman visit for a clinical breast exam.

Breast Cancer in Hispanic Women

According to a research done by Dr. Amelie Ramirez from the University of Texas Health Science Center at San Antonio and a Komen scholar with Susan G. Komen, breast cancer is the leading cause of cancer death for Hispanic women in the U.S. She explains that survival rates are lower partly because many Hispanic women do not receive regular screenings, such as mammograms and clinical breast exams, or they lack access to appropriate care. All of these are the factors that contribute to these disparities.

Breast Cancer in Women Over 50

Per the CDC, “The risk for breast cancer increases with age. Most breast cancers are diagnosed after age 50.” This could be because many women in their 50s have had more years of menstruation, which means they have had more estrogen in their system.

What Happens During a Mammogram?

Mammograms are nothing to be afraid of! While they can be a little uncomfortable, the whole test takes only 15 minutes or less. Here’s what to expect:

You will undress from the waist up and put on a medical gown.
The technician will place your breast between two plastic plates for scanning.
The plates press down for a few seconds to get clear pictures.
You will hold still while each picture is taken.
A few pictures of each breast will be taken from different angles.
Results go to your doctor. For screening tests, you will hear back in a few days; for diagnostic tests, you will sometimes see results the same day.

How to Prepare for a Mammogram

Many women feel anxious or nervous about getting a mammogram, but it is a quick and simple test. Here are some tips to help you prepare and feel more comfortable:

Schedule your mammogram for the week after your period, when your breasts are less likely to be tender.
Wear a shirt and pants or a skirt, so you will only have to remove your shirt for the screening.
Do NOT wear deodorant, powder, lotion, or perfume on the day of your mammogram, because these can show up as questionable areas and cause you to have to go back for a rescreening.
Shower well on the morning of your mammogram to wash away any leftover deodorant, powder, lotion, or perfume from the day before.
Reduce caffeine consumption a few days before and on the day of the mammogram. Caffeine can cause breast tenderness in some people.

What Happens If You Get a Call Back?

If your radiologist or doctor asks you to return for additional screenings, don’t panic! This is a very normal occurrence. Most women who get regular mammograms will experience at least one call back in their lives. This does NOT mean you have breast cancer.

If the radiologist cannot clearly see all the details in the images from your mammogram, they may call you back as a precaution and to get more images. These are some common reasons you may get a call back on your mammogram, according to VeryWell Health:

Inconclusive results: calcifications, fibroids, dense breast tissue, asymmetry, or breast tissue pulling away from the nipple.
First mammogram: more information may be required to establish a detailed baseline image for future comparison.
Unclear X-rays: while the technician will try their best to make sure the images are clear, the doctor may want better pictures.
Changes in the appearance of breast tissue when compared to previous imaging.
Medical history: breast cancer survivors and breast cancer patients are more likely to be called back for further images, as their tests are being closely monitored for anything new or different.

When you get a callback, your doctor may request either a follow-up mammogram (diagnostic mammogram), breast ultrasound, or breast MRI. If there is any doubt about the presence of breast cancer, a biopsy may be needed. A biopsy is where a doctor removes a small amount of tissue in the breast to check for cancer.

Schedule your mammogram today and take control of your health!

If you are over 40, you can make an appointment for a screening mammogram at an imaging center in network with your health plan without a referral. You can also call your primary care provider or OBGYN if you have mammogram questions or if you’re not sure when or where to schedule.

Community First Member Services can also help our health plan members find care.

Call 1-800-434-2347 or the number on the back of your Member ID card to speak with someone who can help.
Log on to the Member Portal or use our online Provider Directory to find an in-network doctor or imaging center near you.