Mammograms: What to Expect During Your First Appointment

Going for your first mammogram appointment can be an unnerving experience. Find out what to expect on your first visit, the do's and don’ts and how to beat pre-mammogram anxiety.

by Ain Nadzirah

Medically Reviewed by Dr Chua Zi Wei.

Feeling scared and anxious about your very first mammogram appointment? You are not alone. But first, give yourself some deserving credit for wanting to try out a mammogram! That means you are practising good self-care for your breast health. 

Mammograms can be intimidating especially for first-timers. Let us guide you through some of the common concerns women have, so you can get ready for your first mammogram experience. 

What is a mammogram?

A mammogram is an X-ray for the breasts. The procedure is typically administered by a licensed mammography technician or technologist who handles the mammogram equipment. Results from the screening will then be assessed for diagnosis by a certified radiologist to be sent to your doctor. 

Mammograms are conducted for two major purposes:

  • To examine non-cancerous symptoms such as breast pain, nipple discharge, and changes in breast shape and surface.
  • To examine abnormal growths in breast tissue that may indicate early signs of breast cancer such as lumps, cysts, or tumours. Sometimes, these growths are too small to be seen or felt by palpation (touch examination). 

Who should get a mammogram?

Women who have no symptoms or breast problems can also get a mammogram as a way of prevention.

However, screening mammograms are recommended every year if you are 40 years old and above, and at least one (1) of the following conditions applies to you: 

  • You are a BRCA1 (BReast CAncer gene 1) or BRCA2 (BReast CAncer gene 2) carrier;
  • You are an untested first-degree relative (mother, daughter, sister) of BRCA1 or BRCA 2 carrier;
  • You have a strong family history of breast cancer; or,
  • You have had prior chest wall radiation.

Is there a difference between screening and diagnostic mammograms?

Yes, the two mammograms serve different functions.

Screening Mammogram

A screening mammogram refers to the annual breast check-up. It is not compulsory but highly recommended by healthcare providers, especially for high-risk women starting at the age of 40, or 30 (if you have a family history of breast cancer). 

Screening mammograms are suitable for women with no symptoms of breast cancer. It acts as the first stage of breast examination. 

The procedure only takes about 10 to 15 minutes and involves two X-rays, one for each breast. Results from your first screening mammograms will act as a point of reference when comparing with future results to monitor any new changes. 

Diagnostic Mammogram

A diagnostic mammogram requires a referral from your doctor and does not apply to women whose results are normal. If suspicious signs are detected from your initial screening mammogram, you may be called back to do this follow-up examination. 

Diagnostic mammograms are used for women who have symptoms of breast cancer, or those who experience unusual breast concerns like a lump, swelling, breast pain, and infection. 

The procedure takes longer than screening mammograms, as more X-ray images are needed to target and zoom in on the specific areas where symptoms are found. 

Which one to choose: 2D or 3D mammograms?

With technology adapting its way into the medical world, we are presented with wider options for quality healthcare services. Mammogram X-rays are now available in 2D and 3D, although some health facilities may not offer 3D mammograms.    

3-D mammograms offer more advanced features such as:

  • X-ray images can be taken from different angles to create a more detailed view of the breast tissues. 
  • Can detect small lumps or tumours that 2-D mammograms might miss. 
  • Can give more accurate results and reduce the possibility of false positives (results showing signs of breast cancer, but turning out to be incorrect). 
  • Suitable for women with dense breasts. 

However, 3D mammograms may be more costly than 2D mammograms. You can ask suggestions from your doctor to weigh in on what is best for you.  

Is it safe to get a mammogram?

X-rays generally expose our body to radiation which can damage cells and lead to cancer, ONLY if the level of exposure is high. 

X-rays used in imaging tests, like mammograms, usually emit very low-dose radiation. Rarely do patients get cancer from X-ray tests alone. Medical experts agreed that mammograms provide more benefits than risks as the procedure has proven to save many lives from breast cancer through early diagnosis and constant monitoring. 

Mammograms are also considered safe for pregnant women, as the radiation only targets breasts or the upper part of the body. A lead apron can be placed on the belly for an additional layer to shield the foetus from radiation exposure. Although, pregnant women with no symptoms and not at high risk of breast cancer are not advised to undergo frequent screening mammograms.

If you are worried about radiation risks, consult with your doctor beforehand so they can suggest better alternatives, such as ultrasound, to minimise health risks.  

How to prepare for your first mammogram?

Preparation for your first mammogram mostly involves self-research. 

Look out for recognised centres

More and more health facilities offer mammograms as one of their medical services, which may get confusing to choose. You want to find a facility that has a department specialising in radiology, a medical field with expertise in imaging technology.

Deciding on a facility that you can trust gives a sense of relief and confidence, knowing that your preferred facility is equipped with (a) certified medical experts and (b) high-quality medical equipment. These two factors are crucial in reducing the probability of false positive test results. 

Be alert to the requirements

With Covid-19 being the new norm, medical facilities are now shifting to telehealth as a convenient way to deliver healthcare services online, including booking appointments. If unsure, check out their official website or social media accounts to find out about the registration procedure, whether you are required to book online or via call. 

Some facilities may also request to fill in forms and other related papers for you to bring on the appointment day. Preparing ahead of time will save you from getting panic-stricken if an issue comes up with your mammogram due to lack of documents.   

Take advantage of discounted and free offers

The price range for a mammogram can reach up to RM300 depending on mammogram packages—which not everyone can afford. 

Keep an eye on promotional packages, especially during Breast Cancer Awareness Month and Pink Ribbon campaigns that offer mammograms as low as RM50. Pay attention to the date validity to ensure the promotion has not expired. 

You might also be eligible for no-cost breast cancer screening through initiatives under the government and non-governmental organisations, for example: 

  • The National Population and Family Development Board (LPPKN) launched a subsidy programme to grant free mammograms to women aged 35 to 70 with a household income of  RM10,000 and below. 
  • Tunku Laksamana Johor Cancer Foundation recently announced free mammograms at Johor KPJ Specialist Hospital for 700 women in Johor aged 40 and above who are from low-income (B40) households. 
  • National Cancer Society Malaysia provides free mammograms for underprivileged women 40 years old and above as part of their community outreach programme

What should you inform your doctor about before and during the mammogram?

In order to get the best quality mammogram results, it Is essential to be transparent with your doctor.

Before mammogram

Aside from your personal background, your doctor will ask several questions to assess your health conditions before proceeding with a mammogram. 

During this medical consultation, you should disclose the following details: 

  • If you have breast concerns such as unusual symptoms or discomfort in your breasts
  • If you have had breast implants 
  • If there is a possibility of being pregnant 
  • If you are currently breastfeeding
  • If you have a family history of breast cancer
  • If you have undergone breast surgeries in the past

During mammogram

Mishaps can occur in the middle of a mammogram procedure. Let your doctor know if you are:

  • In pain: It is normal to feel pressure or uncomfortable when the mammogram equipment is compressing your breasts. If it causes unbearable pain, alert your doctor to make adjustments. 
  • Unable to stand steadily: For wheelchair users and patients with physical disabilities, you can request to do the mammogram in a seated position. 
  • Feeling lightheaded: Patients who are prone to fainting can ask the mammogram technologist for assistance. 

Tips for a comfortable mammogram 

Being clueless about what you should or should not do during a mammogram is totally normal. 

Read up on these tips and precautions to ensure your first mammogram experience goes smoothly with minimal discomfort.

Mammogram do’s

  • Schedule your mammogram after your period

Your breasts tend to get swollen before and during your menstrual period. Having sore breasts may cause intense discomfort when the mammogram compresses them for X-ray imaging. 

The best time to book a mammogram is a week after your period ends, as your breasts will be less sensitive and not as tender by then. 

  • Opt for a two-piece outfit. 

As you will need to undress your breasts during a mammogram, wearing a separate top and a bottom is more convenient—removing only your shirt or blouse. 

With a one-piece outfit like a dress or jumpsuit, taking off the whole clothing will leave your body fully exposed. A hospital gown is usually provided; however, it may still be an experience to consider.

  • Wear comfortable footwear.

A mammogram requires positioning your body at different angles to obtain thorough X-ray images. Hence, standing in high heels may not be ideal. You can wear sneakers or flats instead to help stabilise your posture.

  • Clean up yourself well.

Bathing before going for your mammogram appointment is a great effort, considering you are not allowed to apply perfumes and deodorants. 

This will help to calm down your nervousness, as well as make the mammogram a pleasant process for both you and your technologist. 

  • Keep your hair up.

If you have long hair, it is better to tie them up so that nothing is covering or blocking your breast area.

Mammogram don’ts

  • Skip the cosmetics and personal products. 

Avoid applying beauty products such as deodorants, body lotions, creams, and talcum powder around your breasts as well as under your arms. 

These substances will appear as white spots on the X-ray that can cause confusion for your radiologists when assessing the mammogram results.  

  • No jewellery.

It is best to not wear your necklace or dangling earrings so that they do not interfere with getting clear X-ray images. Any piercings on the upper body should also be removed. 

  • Cut down on the caffeine. 

Caffeine includes coffee, tea, and carbonated beverages. A study by the National Institutes of Health suggests that caffeine consumption may have an indirect impact on oestrogen levels. If levels of oestrogen are high, it can lead to breast tenderness. 

Hence, reducing your intake of caffeinated drinks or avoiding them altogether before your mammogram is a safer choice. 

What to expect when waiting for your results?

Wondering how long the mammogram report takes to be done is a common worry while waiting for your results.  

Depending on which type of mammogram, you may expect:

  • screening mammogram results usually within two weeks. 
  • follow-up mammogram results to be ready instantly on the same day of your test. 

Not hearing from your doctor after two weeks does not necessarily mean there is an issue with your results. Sometimes, different mammogram centres may take a shorter or longer time to process due to various reasons, like a high number of patients. 

You can always contact your healthcare provider to follow up, just to put your heart at ease from worrying.   

My results are normal. What now?

You can now sigh in relief! 

Before going home, seek advice from your doctor on whether you should return the following year for a routine screening mammogram. You may also ask them to explain the report findings to better understand your breast health in-depth. 

What if my results are abnormal?

If the X-ray images display abnormality s, the radiologist may ask you to return for a diagnostic mammogram to obtain additional X-ray images or to proceed with ultrasound and subsequently biopsy. This can be scary but try not to freak out first—most of the time, the results turn out to be a benign (harmless) lump or cyst which can be treated.

In the case that the results confirm that you have breast cancer, do know that it is also a good sign being detected at an early stage, as the cancer is still small. You are also more likely to have plenty of treatment options and a promising chance of survival.  

Ways to beat pre and post-mammogram anxiety

Thinking about the worst-case scenarios before and after going for your first mammogram is common, but can be managedthe key is preparation. 

Here is a list of steps to help you minimise mammogram anxiety:

  • Discuss with your doctor first, whether it is necessary for you to get a mammogram.
  • Be informed of the details and instructions provided by your chosen mammogram centres. You can read up on their website, or visit their facility to ask directly. 
  • Get all the required documents ready ahead of time. Do not forget your identification (ID) card. 
  • Do research before deciding on which facility to go to, the costs, and the best date to schedule. 
  • Educate yourself on the basics to give you a general picture of what to expect. Learn more about mammograms 101 here
  • Talk to a fellow mammogram patient. Listening to personal stories from family members or friends who have undergone the procedure can give a sense of encouragement.
  • Bring a loved one! Having someone accompanies you on the appointment day, or getting mammograms together 
  • Remind yourself of the long-term benefits of mammography.
  • Seek emotional support from your loved ones if you feel devastated after getting your results. 
  • Focus on the potential of successful treatments can help boost your spirit and distract you from negative thoughts.
References
About the Writer
Ain Nadzirah
Ain is just another small-town film buff who treats her car rides as a stage to belt out show tunes and musicals. It is not a strange sight to spot her talking to her 14 cats at home, or arguing with her grandma over having too many (and counting) potted flowers.
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