Mammogram Guidelines: When to Start, How Often to Schedule, and What to Expect at Rush Memorial Hospital

Mammogram guidelines can feel confusing.

You may hear that screening starts at 40, but then wonder if that means every year, every other year, or something different if breast cancer runs in your family. You may also have questions about what actually happens during the appointment, whether it hurts, how long it takes, and what it means if you’re called back for more images.

At Rush Memorial Hospital, we want breast cancer screening to feel less uncertain. A mammogram is a low-dose X-ray exam that helps look for changes in breast tissue. It can help find breast cancer earlier, sometimes before a lump can be felt or symptoms appear.

For many women and people assigned female at birth who are at average risk, the U.S. Preventive Services Task Force recommends screening mammograms every other year from ages 40 to 74. Some people may need a different plan based on family history, genetic risk, prior breast concerns, dense breast tissue, symptoms, or their provider’s recommendation.

The most important thing to know is this: mammogram guidelines are a starting point. Your personal screening plan should be based on your age, health history, family history, breast density, symptoms, and comfort level after talking with your provider.

When should you start getting mammograms?

For many people at average risk, mammogram screening starts at age 40.

That does not mean every person has the exact same screening plan. Some people may need to start earlier, screen more often, or have a different type of follow-up based on their risk factors.

You should talk with your provider about your mammogram plan if you have a parent, sibling, or child who has had breast cancer, especially if they were diagnosed at a younger age. You should also speak with your provider if you have had a previous breast biopsy, dense breast tissue, a known genetic risk such as a BRCA mutation, a history of chest radiation, or a previous breast cancer diagnosis.

Rush Memorial Hospital’s Routine Cancer Screenings resource also notes that family history can affect when cancer screening should begin, and that your healthcare provider is the best person to help determine when to screen and what type of screening is appropriate.

How often should you get a mammogram?

For average-risk patients, the U.S. Preventive Services Task Force recommends a mammogram every other year from ages 40 to 74.

Other medical organizations may have slightly different recommendations, which is one reason mammogram guidance can feel confusing. Some providers may recommend annual screening based on your risk, preferences, or medical history.

The best next step is to ask your provider, “How often should I get a mammogram based on my risk?”

That conversation can happen during an annual wellness visit, a primary care appointment, or a visit with a women’s care provider.

Who may need a different mammogram plan?

Average-risk guidelines do not fit everyone.

You may need a more personalized screening plan if breast cancer runs in your family, especially in a close relative. Your provider may also recommend a different plan if you have dense breast tissue, a prior abnormal mammogram, a previous breast biopsy, a known genetic risk, or certain symptoms.

Symptoms matter, too. A screening mammogram is meant for people who do not have breast symptoms. If you notice a new lump, nipple discharge, nipple changes, skin dimpling, breast swelling, redness, or a change that feels unusual for you, call your provider. You may need diagnostic imaging instead of a routine screening mammogram.

What is the difference between a screening mammogram and a diagnostic mammogram?

A screening mammogram is used when you do not have breast symptoms. It is done to look for changes that may not be felt or noticed yet.

A diagnostic mammogram is used when there is a specific concern. That might be a lump, pain, nipple discharge, a change seen on a screening mammogram, or an area that needs a closer look.

Being asked to come back for diagnostic images does not automatically mean cancer. It means the radiologist needs more information before giving a clearer answer.

What does dense breast tissue mean?

Dense breast tissue is common, but it can be confusing when you see it on a mammogram report.

Dense breasts have more glandular and connective tissue compared with fatty tissue. You cannot tell whether you have dense breasts by how your breasts look or feel. Breast density is seen on a mammogram.

Dense tissue matters because it can make a mammogram harder to read. Rush Memorial Hospital’s article on dense breast tissue explains that fatty tissue appears dark on a mammogram, while glandular tissue, connective tissue, and cancerous tissue appear white. When more tissue appears white, changes can be harder to spot.

Dense breast tissue does not mean you have cancer. It does mean your provider may want to talk with you about your overall risk and whether any additional screening or follow-up makes sense for you.

How do you schedule a mammogram at Rush Memorial Hospital?

If your provider recommends a mammogram, Rush Memorial Hospital’s Imaging/Radiology Department offers mammography close to home. Rush Memorial Hospital’s mammography information notes that mammograms must be ordered by a provider and then may be scheduled directly with the Imaging Department.

If you already have a primary care or women’s care provider, ask whether you’re due for screening and what type of mammogram is recommended. If you do not currently have a provider, Rush Memorial Hospital’s Primary Care team or Women’s Care can help you start the conversation.

Rush Memorial Hospital’s current mammogram page directs patients with mammography questions to contact the RMH Imaging Department at 765-932-7556.

How should you prepare for your mammogram?

On the day of your mammogram, avoid wearing deodorant, lotion, powder, perfume, or cream on your chest or underarms. These products can show up on mammogram images and may make the exam harder to read clearly.

It can also help to wear a two-piece outfit. You’ll be asked to undress from the waist up, so wearing a shirt with pants or a skirt may feel easier than wearing a dress.

Before the exam, tell the technologist if you have breast implants, have had breast surgery, are breastfeeding, have noticed a breast change, or have had prior mammograms somewhere else. If this is your first mammogram, it’s okay to say that, too.

If your breasts are usually tender around your menstrual cycle, you may feel more comfortable scheduling your mammogram when tenderness is less likely.

What happens during a mammogram at Rush Memorial Hospital?

Your mammogram is performed in a private imaging room.

You’ll be asked to undress from the waist up and will be given a covering for privacy. A technologist will position one breast at a time on the mammography machine. The machine applies compression to the breast so the imaging team can get a clear picture of the tissue.

The compression may feel uncomfortable, but it only lasts briefly. Rush Memorial Hospital’s mammography page notes that compression lasts about 20 seconds per image and that the full procedure takes about 20 minutes.

The technologist will guide you through each step, help position your body, and let you know when to hold still. You may be asked to briefly hold your breath while the image is taken.

Does a mammogram hurt?

A mammogram can be uncomfortable, but the pressure is usually brief.

Compression is needed because it spreads out the breast tissue and helps create a clearer image. The CDC notes that mammograms are uncomfortable for most women and painful for some, but the discomfort does not last long.

Tell the technologist if you’re very uncomfortable. They can explain what’s happening, help you adjust your position, and let you know how much longer the compression will last.

What is 3D mammography?

3D mammography, also called tomosynthesis, creates breast images from multiple angles. This can help the radiologist review breast tissue more closely.

Rush Memorial Hospital offers 3D mammography through the Imaging/Radiology Department. Rush Memorial Hospital has also earned ACR Gold Seal Accreditation in mammography, which reflects image quality and patient safety standards, including review of equipment, personnel qualifications, quality control, and quality assurance programs.

For patients, that means mammography at Rush Memorial Hospital is not just about getting the exam done. It’s about having the exam performed with attention to quality, safety, and accurate imaging.

What happens after your mammogram?

After your mammogram, a radiologist reviews the images and sends a report to your ordering provider. Rush Memorial Hospital’s mammography page also notes that patients receive a letter from the Imaging Department with their results.

Your result may say that everything looks normal. It may also say that more images are needed. A callback can feel stressful, but it does not automatically mean cancer.

Sometimes the radiologist needs a clearer view. Sometimes an area needs to be compared more closely. Sometimes dense tissue, overlapping tissue, or a first mammogram can lead to more imaging because there are no older images for comparison.

The CDC explains that an abnormal mammogram does not always mean cancer, but additional mammograms, tests, or exams may be needed before your provider can know for sure.

What if you’re called back after a mammogram?

If you’re called back, do not ignore it.

A callback may involve additional mammogram images, a diagnostic mammogram, an ultrasound, or another type of follow-up. The purpose is to get a better look and give your care team clearer information.

Many callbacks do not lead to a cancer diagnosis. They may turn out to be normal breast tissue, a cyst, dense tissue, or another benign finding. But follow-up matters because it helps your provider and radiology team know what is happening.

What should you ask your provider about mammogram guidelines?

You do not need to memorize every guideline before your appointment.

Start with the questions that matter most for your situation. Ask when you should start screening, how often you should get a mammogram, whether your family history changes your plan, and whether dense breast tissue affects your screening needs.

You can also ask whether you need a screening mammogram or diagnostic imaging, when you should expect results, and what symptoms should prompt a call before your next routine screening.

If you have a close relative who had breast cancer, try to share who it was and how old they were at diagnosis. If you’ve had previous breast imaging, a biopsy, genetic testing, breast surgery, or a prior abnormal result, tell your provider that, too.

How primary care and women’s care support breast screening

Mammograms are part of preventive care.

Your primary care provider or women’s care provider can help you understand when to start screening, how often to repeat it, and whether your personal risk factors mean you need a different plan. They can also help you keep track of other preventive screenings, medications, family history, and health changes over time.

Rush Memorial Hospital’s Women’s Care team provides preventive examinations and screenings, including routine cancer screening support. Rush Memorial Hospital’s Primary Care team can also help patients stay connected to preventive care close to home.

Mammogram guidelines are personal

Guidelines are helpful, but they are not the whole story.

For many people at average risk, screening starts at 40. Some people need a different plan because of family history, breast density, symptoms, prior results, or other risk factors.

The best screening plan is the one you understand, feel comfortable discussing, and follow through on.

At Rush Memorial Hospital, mammography is available close to home through the Imaging/Radiology Department. If you’re due for a mammogram, unsure when to start, or wondering whether your family history changes your risk, talk with your Rush Memorial Hospital provider.

You can also contact RMH Imaging at 765-932-7556 with mammography questions.

Medical Disclaimer
This blog is for general informational purposes only and isn’t a substitute for medical advice, diagnosis, or treatment. Always follow guidance from your healthcare provider. If you think you’re experiencing a medical emergency, call 911 or go to the nearest emergency room immediately.