When should you have a mammogram and how often?

The biggest question we hear is: when should I begin screening for breast cancer and how often? We love this question because the best way to beat breast cancer is to detect it early—and proper screening can help us do just that. WHA follows the guidelines of the American College of Obstetricians and Gynecologists (ACOG) and the American Cancer Society, which are in agreement. So, what does that actually mean? For women and other people assigned female at birth who have not had top surgery, it means:

• You should know how your breasts look and feel normally and report any changes to your healthcare provider. Normal can be different from one person to another. It’s important to have a conversation with your provider about what your “normal” breast tissue characteristics are.
• You should have a provider examine your breasts every two to three years beginning at age 20; annually beginning at age 40.
• You should have a mammogram to screen for breast cancer every year beginning at age 40.
• People with a family history or other risk factors for breast cancer should consult with their provider to determine the screening modality and frequency that is right for them.

We will help assess your individual risk and provide screening recommendations to help you decide what is right for you. People with higher risk histories may choose to start screening earlier and have it done more frequently. Others, such as younger people with low-risk histories, may choose less frequent screening. The choice is personal; we are always here to help you understand the best available science and decide what’s right for you.

Breast cancer screening during pregnancy and breastfeeding

Previously, recommendations were to only evaluate for breast cancer during pregnancy if someone noticed a lump or other concerning symptom. As people have children at an older age and our understanding of risk and tools for individualized risk assessment become more sophisticated, we have updated our recommendations to be aligned with the American College of Radiology: pregnant or lactating people can continue or begin breast cancer screening with minimal risk to the pregnancy and fetus.

Technology and expertise matter

WHA uses 3D mammography, also known as breast tomosynthesis, to capture the most detailed images possible. 3D mammography allows our radiologists to examine the breast tissue in layers, which is especially helpful for dense breast tissue. In studies, 3D mammography has been shown to increase the number of breast cancers detected and to decrease the number of call-backs for follow up mammography or breast ultrasound.

In addition to using the latest technology, WHA works with a team of local radiologists from Diagnostic Imaging Northwest who specialize in reading mammograms. Two separate radiologist with expertise in mammography independently evaluate each mammogram, comparing to past exams, when available, and helping you stay on top of your breast health.

What to expect

During mammography, a certified technologist will place your breast on a platform that is part of the mammography machine and then compress your breast with a paddle (sounds dreamy, right?). You will feel pressure; for most, it is only mildly uncomfortable. If you do have discomfort, just let the technologist know and they will use less pressure and/or fit the mammography unit with special pads designed to decrease discomfort. As a side note, you know what feels great after a self-care-filled mammogram appointment? A cup of fancy tea in your favorite chair.

Prior mammograms

If you’re new to mammograms at WHA but not new to mammograms, we need to know where to find your prior images. (Like, exactly where to find them.) Why? One of the biggest reasons is avoiding the anxiety-provoking call-back for additional views. If we know another radiologist has already looked into an area and determined it’s nothing to worry about, we don’t have to do the same. Another (equally important) reason is a lot of what we do during routine screening is look for changes since your previous screening. And if we don’t have your previous screening–well, you get how this presents a challenge. Bottom line: if you’ve had mammograms elsewhere, we need to know where to find them. In the case of out-of-state imaging centers, we’ll likely need your written permission to get them. Be prepared – download and complete a Medical Records Release Form >