By Trisha Fernandez, RT (R)(M) ARRT
Most people know mammograms are important, effective screenings that save lives. Even so, many women do not get a regular mammograms, or in some cases, at all. One of the main reasons is they expect it to be uncomfortable. Others are shy about having their breasts exposed.
Older women who had a mammogram a decade or two ago might remember it being painful. My own mother had her first mammogram when she was 40, and it left her uncomfortable and embarrassed. After that, she put off having a mammogram for decades. I suspect many women put it off for similar reasons.
I broached the subject with my mom and told her mammograms have changed quite a bit since she had hers. Modern mammography machines are designed to be more comfortable, with curved edges that won’t dig into the ribs, and the amount of compression used to flatten out the breast is more precise, causing less discomfort.
In terms of modesty and embarrassment, I want women to know that they are never completely topless during the procedure – a hospital gown is worn throughout the mammogram with only one breast at a time exposed for the imaging. It also may help to remember that mammogram technologists are experienced health care professionals who work with hundreds of patients a year. In short, they have seen it all when it comes to breasts, so no need to be self-conscious.
Knowing what to expect when getting a mammogram can help ease anxiety.
First, preparing for a mammogram starts before the patient arrives at the facility. When patients make the appointment, mammography staff should tell the patient not to wear perfume, power, including glitter power, or deodorant to their appointment. Such substances can show up as an abnormality on the mammogram image.
Most of the time, the whole experience takes about 15 minutes. When the patient arrives, the technologist takes them to the mammography room and asks about their health history and that of their family. It is especially important for the technologist to know if the patient’s mother, sisters or grandmother had breast cancer. If I think the patient is nervous, I’ll talk to them a little longer and answer any questions they may have.
Next, the technologist will leave the room while the patient removes their clothing from the waist up and puts on a hospital gown so it opens to the front.
When the patient is ready, the technologist will return and start the mammogram. The patient will face the machine and the technologist will position their breast on the plate and use a top plate to compress the breast for each image. The technologist will capture images from two different angles for each breast — one from top to bottom and one from side-to-side. Depending on the patient’s body type, the technologist may take more images. The goal is to get as much breast tissue in the image as possible, including from under the arm to the bottom of the breast.
After the mammogram is completed, the patient is free to get dressed and leave. A radiologist will read the image and send the results to the patient’s primary care physician. Most facilities also will send the patient a letter with the results.
Other things to know:
- Most women get their first mammogram between the ages of 40 and 50, depending on their primary care physician’s recommendation. Women with a family history of breast cancer may start getting regular mammograms at an earlier age.
- The first mammogram is important because it is a baseline used for comparison with later mammograms.
- Women with breast implants can and should get regular mammograms. The mammogram compression and positioning of the breast is a little different.
Trisha Fernandez, RT (R)(M) ARRT, is the clinical operations supervisor at Bexar Imaging, a WellMed company. She graduated from Baptist School of Health Professionals in San Antonio, Texas and is a registered Radiologic Technologist and has a license in mammography and is a registered mammographer. Trisha joined WellMed in 2003 and served as Bexar Imaging’s lead mammographer until 2019, when she was promoted to her present position. Trisha assists the Bexar Imaging director and oversees operations of the mobile mammogram unit in both clinical and administrative capacities. Trisha continues to fill in for technologists whenever needed to fulfill her passion for helping and caring for patients.