Questions & Answers regarding Mammography

Mammograms

A mammogram and a clinical breast exam on a regular basis are the most effective ways to detect breast cancer early.   The Yale Health Plan follows the recommended mammography guidelines that encourage women ages 40-49 to have a mammogram every one to two years, and women 50 and older to have mammograms yearly. Yale Health Plan members do not need referrals for screening mammograms.

What is a mammogram?

A mammogram is a safe test which uses a low-dose x-ray machine to take pictures of and look for problems with a woman’s breasts. Results are recorded on x-ray film or directly onto a computer. Mammograms allow radiologists to look for breast lumps and changes in breast tissue. They can show small lumps or growths that may not be felt during a clinical breast exam.

How often should I get a mammogram?

While you should talk to your clinician about when to start and how often you should have a mammogram, YHP has adopted the following guidelines:

• Women 40 years and older:  every one to two years.
• Women 50 years and older: every year.
• Women who have had breast cancer or other breast problems or who have a family history of breast cancer might need to start getting mammograms before age 40, or they might need them more often.

Several reputable organizations such as the American Cancer Society, US Preventive Health Task Force, and the American College of Obstetricians and Gynecologists make similar recommendations about the frequency of mammography.

Where can I make an appointment for a mammogram?

YHP members may obtain screening mammograms at any one of the following facilities:  the Yale Mammography Center, the Yale New Haven Long Wharf Facility or at the Mobile Mammography Van.  Call 203-688-6800 to schedule an appointment.

Do I need a referral?

YHP members do not need referrals for screening mammograms.  However, please give the mammography center your primary care clinician’s or ob-gyn clinician’s name so your results can be forwarded.  Your clinician may give you a requisition at your appointment. It is helpful if you bring this requisition to your appointment; however it is not required. If the Yale Health Plan is not your primary insurance, please verify coverage and the need for a referral with your primary insurance company.

Are there different types of mammograms?

• Screening mammograms are for women who have no breast problems or symptoms of breast cancer. When you reach age 40, you should have a screening mammogram every one to two years. 
• Diagnostic mammograms are performed on women who have breast problems or symptoms, such as lumps, nipple discharge, or as a follow up to screening mammograms.
• Digital mammograms take an electronic image of the breast and store it directly in a computer. Current research has not shown that digital images are better at finding cancer than x-ray film images.

How is a mammogram done?

The person who takes the x-rays, called a radiologic technologist, places one breast at a time between two plastic plates, which press the breast to flatten it. You will feel pressure and possibly some discomfort for a few seconds.  The flatter your breast is, the better the picture. Usually, two pictures are taken of each breast--one from the side and one from above. A screening mammogram appointment takes about 30 minutes from start to finish.

Is the mammogram going to hurt?

Adequate compression is necessary for the radiologist to see the breast tissue better.  Compression of the breast also lowers the radiation dose. Women who have tender breasts may experience discomfort.  If you are afraid or nervous about feeling pain during your mammogram please discuss this with the technologist before the examination.  The technologist will work with you to make you as comfortable as possible while still taking good-quality images.

How do I get ready for my mammogram?

Check with the place where you are having the mammogram for any instructions you may need to follow before you go. Some general guidelines:

• Before your mammogram discuss any new findings or problems in your breasts with your primary care or ob-gyn clinician.  In addition, inform your clinician of any prior surgeries, hormone use, and family or personal history of breast cancer.
• Make your appointment for one week after your period, when your breasts are less likely to be tender.
• Bring previous mammograms, breast sonograms, and reports to your appointment so that they are available to the radiologist, who needs the prior information in order to make comparisons to your current mammogram.
• Describe any breast symptoms or problems to the technologist performing the exam. Inform the technologist of your previous breast history.
• Inform the technologist of the date of your last clinical breast exam and your menstrual cycle (if appropriate).
• Wear a shirt and a separate bottom, rather than a dress. This way, you can undress from the waist up and leave other clothes on.
• Avoid coffee, tea or caffeinated soft drinks for a few days, before a mammogram. Caffeine can cause breast tenderness.
• Don't wear deodorant, perfume, lotion, or powder under your arms or on your breasts on the day of your appointment, as these can cause shadows on the mammogram.
• If you have breast implants, be sure to tell your mammography facility when you make your appointment. You will need a technologist who is trained in x-raying patients with implants because breast implants can hide some tissue.

How will I get the results?

The facility will send you a letter with the results of your mammogram. In addition, a report is also sent to your YHP clinician.  Please make sure that you follow up with your clinician to discuss the results of your examination.

Should I be worried about radiation dose?

Mammography involves a very low dose of radiation to the portion of the breast under exam.  The dose is much lower than the natural level of radiation that every person receives from the environment during one year.  For example, the average mammogram (four views) has a typical effective radiation dose of 70 millirems (a measure of radiation dose equivalent).  As a comparison, the average person in the US receives a dose equivalent of 300 millirems per year from natural sources.

For more information...

Call the YHP Ob-Gyn Department at 203.432.0222 with any questions. 
Or refer to the following web-sites:

National Cancer Institute’s Cancer Information Service
Phone Number:  800.422.6237
Internet Address: http://cis.nci.nih.gov/ or to chat on-line: http://www.cancer.gov/ and click on “LiveHelp® online chat”

American Cancer Society
Phone Number:  800.227.2345
Internet Address: http://www.cancer.org/

Susan G. Komen Breast Cancer Foundation
Phone Number: 800.462.9273
Internet Address: http://www.komen.org/