What to expect at a mammogram: A complete guide for women

A mammogram can feel like a big moment, especially when it’s your first mammogram. It’s a reminder to pause, think about your health and take a step that can feel both empowering and overwhelming at the same time. For many women, a mammogram is also one of those appointments that’s easy to delay. Maybe you’ve heard it’s uncomfortable, maybe you’re worried about what the results might show or maybe you don’t know what actually happens during the exam.

Whether you’re preparing for your first mammogram or returning after a few years without one, understanding what to expect at a mammogram can help you feel more confident and aware when walking into your appointment.

What is a mammogram?

A mammogram is a special kind of low-dose X-ray exam of the breast that helps doctors look for signs of breast cancer, often before you can feel anything unusual yourself. During the test, a machine takes pictures of your breast tissue, so a radiologist, a doctor trained in reading imaging, can check for any changes or abnormalities.

There are two types of mammograms, screening and diagnostic:

• Screening mammograms are routine exams for women who have no symptoms. They’re essentially a preventive check-in to look for anything out of the ordinary. These typically involve a couple of images of each breast to capture a full picture of the tissue.
• Diagnostic mammograms, on the other hand, are used when you have symptoms, such as a lump, pain, changes in shape or if something unusual was seen on a screening mammogram.

Why do mammograms matter?

Breast cancer is the most common cancer diagnosed in women in the United States (except for skin cancers), and it’s the second-leading cause of cancer death among women. About one in eight women will develop invasive breast cancer in her lifetime. 

Because most breast cancers have no obvious symptoms early on, regular mammograms are a key tool for early detection. Early detection often means smaller tumors, less aggressive treatment and better outcomes.

Current breast cancer screening guidelines

Breast cancer screening recommendations are based on ongoing research and are designed to help you get screened at the right time for your health and risk level.

The current guidance for women at average risk of breast cancer promotes earlier and regular screening. Catching breast cancer when it’s small and hasn’t spread can improve treatment success.

• Women ages 40–44 have the option to start yearly mammograms. (At Baylor Scott & White, we support the recommendation that women with average risk should get their first mammogram at age 40).
• Women ages 45–54 should have a mammogram every year.
• Women 55 and older can switch to mammograms every two years, or continue yearly screening based on personal and medical decisions.

Women at higher-than-average risk, who have a family history of breast cancer, known genetic mutations like BRCA 1 or BRCA 2, or prior chest radiation, may start mammograms earlier, typically around age 30.

Learn more about our high-risk breast cancer screening program

What to expect at a mammogram

If you’re getting ready for your first mammogram, a little preparation can help the day seem less scary and make you feel more comfortable. When scheduling your appointment, you may find it helpful to choose a time when your breasts are least likely to feel tender, such as about a week after your period.

On the day of your exam, consider wearing a two-piece outfit, which makes it easier to undress from the waist up and change into a gown. It’s also recommended that you skip the use of deodorant, antiperspirant, lotions or powders under your arms or on your breasts, as these products can interfere with imaging.

If you’ve had prior breast imaging at another facility, bringing those records can be helpful so the radiologist can compare past images with your current exam.

What happens during a mammogram?

When you arrive for your mammogram, you’ll check in and be shown to a private changing area where you’ll put on a gown. A trained technologist will guide you into the imaging room and carefully position your breast on the mammogram machine.

To capture clear, detailed images, the machine gently compresses the breast for a few seconds at a time. While this pressure may feel uncomfortable for some women, it is brief and allows the technologist to see as much breast tissue as possible. A typical screening mammogram includes two images of each breast and usually takes just a few minutes once the imaging begins.

Does a mammogram hurt?

One of the most common concerns women have before a mammogram is whether it will be painful. Most women describe the sensation as pressure or squeezing, rather than sharp pain. Rest assured that any discomfort is brief. If you’re concerned about pain, talk with your technologist. Making slight adjustments in positioning or timing can help.

Related: Top 5 myths women believe about mammograms

After the mammogram: Results and follow-up

After your mammogram, your images are reviewed by a radiologist. Most screening mammograms are normal and require no follow-up. Results are usually available within a few days. You will most likely receive your results through your primary care provider or in a patient portal, like MyBSWHealth. You may also receive a letter in the mail with your results.

Approximately 10% of women are asked to return for a diagnostic mammogram because something on the initial images needs a closer look. A follow-up for an abnormal mammogram does not mean you have cancer. Oftentimes, the result is still normal after additional imaging. In some cases, a biopsy may be recommended or you could be asked to return for a six-month follow-up exam.

Your breast health beyond the mammogram

Mammograms are an important part of your preventive care, but they’re just one part of your overall breast health. Be aware of how your breasts normally look and feel and report any changes, such as new lumps, persistent pain, skin texture changes or nipple discharge, to your healthcare provider right away.

It’s also important to know your family history and other risk factors for breast cancer, as they can influence your screening plan.

Regular mammograms are one of the most effective ways to find breast cancer early. Early detection continues to be linked to improved survival, with breast cancer death rates declining over the past few decades, thanks in part to regular screening and better treatment options. 

If you’re approaching the age to start mammograms or it’s time for your next screening appointment, talk with your health care provider about what’s right for you. Staying consistent with mammograms is a simple but powerful step toward protecting your long-term health.

Schedule your mammogram today and start an annual routine that protects your well-being for years to come. You can schedule online when and where it’s convenient for you, without the need for a doctor’s order.