What to Expect at Your First Diagnostic Mammogram

written by BRIDGET BAUM
Source: Shutterstock
Source: Shutterstock

As a woman in her 30s and 40s in a time of breast cancer awareness, it’s probably hard to miss the many mentions and recommendations for breast exams. Self-checks and annual visits are encouraged by an abundance of sources. We’ve all likely seen the pamphlets and the diagrams of how exactly you’re supposed to check for lumps.

But less information is out there on what happens if we find a lump or abnormality. What do we do? What can we expect if we do find something during our exams? It can feel scary and foreign, but the truth is, scheduling and going in for a diagnostic mammogram doesn’t have to be a negative experience. Here, using my own experience as well as the advice of a medical professional, I’ll tell you what you can expect from most diagnostic mammograms.

Types of Mammograms and Breast Cancer Screenings

First, what are we talking about when we say “diagnostic mammogram?” There are a few different types of procedures used in breast cancer screening. They may include:

Screening Mammogram: A regularly scheduled mammogram that tracks any changes in breast tissue for a woman who has no sign of breast cancer.

Diagnostic Mammogram: A mammogram used to evaluate a change or concern discovered in a regular mammogram or exam.

Breast Ultrasound: A breast ultrasound is used to more closely view a specific lump or cyst. This can be used at the same time as a diagnostic mammogram to rule out any concerning characteristics of a cyst, such as irregular edges or fluid.

I spoke with a medical professional at a breast cancer center and she provided some insightful perspective on how women should prepare for and approach mammogram appointments, as well as how she and other staff are prepared to meet patients’ needs in what can be a high-anxiety experience. Here, I’m sharing her insights as well as my own personal experience getting a diagnostic mammogram.

When You Notice a Lump

When I was 37, I was doing a routine breast self-check and discovered a tiny, hard, pencil-eraser-like lump in my breast. My mind raced through all of the stories I have heard of women finding a lump in their breast. What was the thing I read about whether or not it’s supposed to be painful? Wasn’t there something about if it moves when you touch it?

I was trying to self-diagnose, and also hoping it would go away. But, after a few days, it was most definitely still there, and I was growing more anxious about it. I called my doctor and scheduled an office visit. She did an exam and agreed the mass should be screened. From there, she put an order in for a diagnostic mammogram. I had no idea what to expect. Being under 40, I had not yet been in for a screening mammogram, and all I could think of were the stories of a machine that painfully squishes your breasts into pancakes while you stand there awkwardly.

My Experience Getting a Diagnostic Mammogram

This might sound surprising, but my appointment for a diagnostic mammogram and ultrasound was the most positive medical experience I can remember to date. From the beginning, every employee I came in contact with was unbelievably kind and reassuring. Honestly, for a mom of a small child who doesn’t fit in a lot of self-care, the experience was almost like being at a spa. Here’s how it went:

Source: Anna Tarazevich | Pexels

The Staff Was Calming and Helpful

All of the women were speaking in quiet, calming tones, every patient was wearing a robe, there were water coolers and comfy sofas, and a small locker room where I locked up my phone and jacket. My impression was that the staff is aware that almost every woman who comes into their office is experiencing a relatively stressful situation, whether it’s routine or diagnostic. With that in mind, they do their best to provide a soothing environment, clearly describing each step of the process and what could be expected next. After my appointment, I told my friend I felt so safe and cared for, it almost brought me to tears.

When I asked my source at the breast cancer center about the caring nature of the staff, she said, “The staff in women’s health are very cognizant and understanding of the heightened anxiety and insecurity that many women have when being seen for a women’s health appointment. The staff makes it a priority to take the time with patients to provide the most comfortable experience possible and to explain everything that will be done during an appointment before proceeding.”

The Mammogram Wasn’t as Uncomfortable as I Expected

I had one tech who walked me through each step of the process. First, I changed into my robe and left my belongings in a locker. Next, we went into the exam room and she clearly explained exactly what was going to happen. She had a calming demeanor clearly honed for these situations. She asked me to identify the lump and placed a tiny metal sticker at the spot so it could be easily found on the mammogram. Then, she had me remove the robe from one side and place my breast on the clear plastic trays of the mammography machine. Now, to be sure, this is not a comfortable exercise. However, I found that it wasn’t nearly as painful or uncomfortable as I had anticipated.

I Didn’t Have to Wait Long for Results

When we were finished with that step, I was taken out to the internal waiting room and my tech let me know that the doctor would be looking at my scan right then to determine whether an ultrasound was needed. Because they decided an ultrasound was the best next step, I was able to get it right then in the same office, with the same staff. I can’t tell you how much this helped my psyche. Not having to go home and worry for a few days while I waited for the next appointment was huge.

The doctor used the ultrasound to get a clearer picture of the lump. From my understanding, she was checking for fluid inside the cyst. She graciously answered my questions and told me while she was performing the ultrasound what she was seeing, and that it wasn’t concerning to her. After about five minutes, the ultrasound was finished, and I had my answer—the mass was a benign cyst that didn’t show any markers of concern. I was told to keep checking it and follow up in a year with another mammogram.

I’m well aware that my experience with diagnostic mammogram will not be the same for everyone. And I was lucky I received good news. However, I hope that by providing an inside look into the experience, I can dispel the anxiety of what exactly the experience will entail.

How to Prepare for a Mammogram Appointment

My source at the breast cancer center shared the following advice on preparing for a mammogram appointment:

  • Avoid wearing a dress or one-piece outfit as patients will need to remove their shirt and bra to wear a patient gown for the mammogram, but can leave pants/skirts on.
  • Avoid wearing jewelry, deodorant, lotions, or perfumes as these may interfere with the imaging.
  • If possible, it is recommended to schedule a mammogram during the second or third week of the menstrual cycle (i.e. a week or two after the start of a period). Breasts may be most tender in the week prior to and during periods, so avoiding mammograms at those times is a good idea so the procedure is less uncomfortable. If scheduling around your period is not an option, it may be helpful to take over the counter pain medication, such as Tylenol or Advil prior to the appointment.
  • Often, the mammogram technologist will need to readjust positions multiple times to get the best views of the entire breasts. It is best to try to relax as much as possible and avoid any motion to get the best images possible.

Alleviating Concerns About Call Backs

I asked my source at the breast cancer center whether she witnesses a common patient concern she could shed some light on for those coming in for their first mammogram. She shared, “When an area of concern is noticed on imaging, women may have a ‘call back’ where they are asked to return for more imaging to take a better look at an area seen on screening mammogram. Women may also be asked to return for a biopsy of an area seen on imaging. This is quite common, but can be very anxiety-provoking waiting for appointments and to receive results. Most call backs do not result in a diagnosis of cancer and are more often to rule out the possibility of cancer.”

She also added, “It is important to know that most breast cancers can be cured when caught early. Keeping up with a recommended mammogram schedule greatly increases the chance that if cancer is found, it is more easily treatable.”

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