Mammogram

A mammogram uses X-rays to check for changes in breast tissue. It’s a breast cancer screening tool, checking for cancerous or pre-cancerous cells before symptoms develop, when the cancer is easier to treat.

We also use mammograms to diagnose breast cancer in people who have symptoms, such as a lump, or who had abnormal results on a screening mammogram. Screening and diagnostic mammograms both use ionizing radiation to produce pictures of breast tissue.

A mammogram machine is designed specifically for breast tissue. Two plates compress your breast to flatten the tissue, which makes it easier to take pictures. The machine sends X-rays through your breast to a detector.

X-rays easily pass through soft tissues such as skin and fat, which appear in shades of gray on the image. Denser structures, such as tumors or deposits of calcium that could indicate breast cancer, absorb the radiation and show up as white on the image.

A screening mammogram uses a very low dose of radiation and typically involves two pictures of each breast. A diagnostic mammogram uses a higher dose of radiation to take more detailed pictures of your breasts from different angles.

Mammograms can be two-dimensional (2D) or three-dimensional (3D). A 2D mammogram takes two pictures of each breast from above and from the side. A 3D mammogram, also called digital breast tomosynthesis, takes pictures from multiple angles because the machine moves around each breast. It also produces more detailed images than a traditional mammogram.

At Penn Medicine, all our mammograms are 3D. We use the latest imaging technology available to provide you with the fastest, most accurate results possible.

Benefits of 3D mammography

Studies show 3D mammography is more effective at finding breast cancer earlier than traditional mammography, especially for people with dense breast tissue. It can also lower the risk of repeat screening mammograms due to false positives (images that look abnormal even though breast cancer isn’t present).

Additional benefits of 3D mammography include:

• Better precision: We can zoom in, magnify, change contrast, and view the breast as individual slices, resulting in more precise images.
• Enhanced comfort: Flexible plates are more comfortable during breast compression.
• Instant availability: Digital images are stored electronically and can be sent to another site or recorded on CDs.

Free mammograms at Penn Medicine

The Penn Medicine Breast Health Initiative offers free mammograms (screening and diagnostic) and diagnostic services like breast ultrasounds and biopsies. These no-cost services are for un- and under-insured women who are older than 40. Other services available through this program include:

• Assistance connecting with a health insurance enrollment specialist
• In-person language interpreters at appointments as needed
• Patient navigation services and breast health education
• Public transportation tokens to assist in getting to and from appointments
• Referrals for free cervical cancer screening and diagnostic services

The American Cancer Society recommends that all women have a screening mammogram annually beginning at age 40. Women 55 and older may choose to switch to mammograms every two years or continue with annual screenings. Your provider may recommend earlier or more frequent mammograms if you’re at an increased risk for breast cancer due to family history, genetics, or other reasons.

In some cases, you may need other types of breast imaging. Talk to your health-care provider about the best screening plan for you.

You may need a diagnostic mammogram if you have signs or symptoms of disease, such as:

• A breast lump you can feel or see
• Breast pain or tenderness
• Changes in breast shape or size
• Discolored, flaky, or puckered nipple
• Irregular results on a screening mammogram
• Nipple discharge
• Thickening or dimpling of breast skin

There’s not a lot of special preparation for a mammogram. It’s best to have your exam when your breasts aren’t swollen or tender, so avoid scheduling your mammogram the week before your period.

Don’t put deodorant, antiperspirant, powder, or lotion on your breasts or underarms the day of your exam, as these can affect the image. Most imaging centers have alcohol wipes available so you can remove these substances. We’ll also ask you to remove jewelry, piercings, and clothing from your waist up.

A mammographer (a radiation technologist who specializes in mammography) performs your mammogram. A radiologist (doctor who specializes in imaging) reviews and interprets your scan. Be sure to tell your mammographer if you have breast implants, are breastfeeding, or think you might be pregnant.

During a mammogram, here’s what you can expect:

1. You put on a gown that opens from the front.
2. The technologist helps you position your breast on a plate. Another plate compresses your breast, which may feel a bit uncomfortable.
3. The technologist steps into another area and takes images. They may ask you to hold your breath for a few seconds at a time.
4. We repeat the process for the other breast.
5. A mammogram lasts between 10 and 15 minutes.

There’s no recovery time after a mammogram. You can return to normal activities right away.

Your health-care provider will receive your mammogram results. By law, you must receive an explanation of your mammogram results within 30 days. You may get a letter in the mail, or your results may be available sooner if you have access to an electronic medical records system. MyChart by myPennMedicine makes it easy for you to view your mammogram results as soon as they’re available.

If you have an irregular mammogram or we call you back for a repeat mammogram, it doesn’t mean you have cancer. False positives do happen. In fact, about 50 percent of women who get annual screening mammograms will have a false positive at some point.

Mammograms are safe. The exam uses a low dose of ionizing radiation, so there is some risk of tissue damage or cancer. But experts agree that the benefits of mammography outweigh the risks of radiation exposure.

At Penn Medicine, we use the most advanced breast imaging technology available to detect breast diseases as early as possible. When you turn to us for breast care, you’ll find:

• National recognition: We are accredited by the American College of Radiology (ACR) in both mammography and stereotactic breast biopsy. Penn Medicine is also home to several ACR-designated Comprehensive Breast Imaging centers.
• Experienced team: We perform more than 24,000 breast imaging studies each year. These studies are interpreted by board-certified and breast fellowship-trained radiologists. Our technical staff is sub-specialty certified in mammography.
• Leading-edge breast procedures: We conduct the highest quality interventional procedures, including stereotactic, ultrasound-guided, and MRI-guided breast biopsies. Radiologists and pathologists with specialized expertise in breast diseases work together to give you the answers you need.
• Multispecialty approach: Radiologists, medical oncologists, radiation oncologists, and surgeons provide collaborative care for people diagnosed with breast cancer. Abramson Cancer Center is a National Cancer Institute-designated comprehensive cancer center.