Methodist Healthcare - November 27, 2020

Mammography is key to early detection and finding a cancer as early as possible is key for a survivor’s journey. “The best way to detect cancer early is a combination of a screening mammogram and physical examination,” says Radiologist, Justin Boatsman, MD.

Still, some women simply brush off their screening mammograms, while others worry about the cost or the potential for pain. Many just aren’t sure how to book a screening or what to expect. With that in mind, we’ve compiled some common questions about getting a mammogram, from making the appointment to getting your results.

Methodist Healthcare offers breast imaging services throughout San Antonio and the surrounding communities through our partner, South Texas Radiology Imaging Centers (STRIC) and our breast center programs at multiple hospitals including:

STRIC offers 22 locations with 5 Boutique Mammography Centers that are dedicated to screening mammography in a comfortable setting designed for women.

Mammo Tips from Dr. Justin Boatsman

When is the best time to schedule a mammogram?

Book an appointment for when your breasts are less likely to be sore or swollen. You may feel less discomfort during the scan, and it can help the technician get better images. For pre-menopausal women, the week following your period is generally a good time. Consider avoiding the week before you menstruate and the week you actually have your period; your breasts may be more sensitive at those times.

Will my insurance cover it?

Medicare covers yearly screening mammography 100% as long as it is within the same calendar month or after as the prior year. Thanks to the Affordable Care Act, signed into law in 2010, most women age 40 and over with private health insurance are covered for annual screening mammograms. If you have private health insurance be sure to check with your carrier regarding screening frequency (every year or every other year) and coverage for the newer 3D mammograms, as some plans may not pay for them yet.

For women whose insurance has been affected by the economic impact caused by COVID-19, we have created a free service to help guide you through the coverage options available based on your unique circumstance. Learn more about our health coverage hotline.

What is the difference between a Diagnostic Mammogram and a Screening Mammogram?

A screening mammogram is an annual mammogram for patients with no current or new breast changes or symptoms. A diagnostic mammogram is ordered by your physician because he/she is aware of breast symptoms or changes requiring work-up and review by the radiologist at the time of your exam. Coverage for diagnostic mammograms is different from screening mammograms and varies by insurance plan. It may involve a co-pay, or you may have to meet your deductible first. Before making an appointment, reach out to your insurance company for details.

How should I prepare the day of the mammogram?

On the morning of your screening, don’t apply antiperspirants or deodorants to your underarms, since bits of either may appear on your mammogram. Skip the lotion, powder or perfume around your breasts and upper arms, as well. Leave necklaces and other valuables at home.

As for your wardrobe, remember that you’ll have to remove any items from the waist up. Instead of one-piece dresses or jumpsuits, opt for two-pieces, a shirt with pants, shorts or a skirt so you don’t have to take off your whole outfit. You will remove your bra and be given a gown or robe to wear during your appointment.

What can I expect during the appointment?

At the appointment, before the actual imaging starts, you’ll likely answer a number of questions to give your healthcare providers (HCPs) some medical background. “We ask about a patient’s family history, personal history, previous medications or procedures,” says Dr. Boatsman. If you’ve discovered any changes in your breasts since your last mammogram, be sure to bring them up. The same applies if you are pregnant, breastfeeding or have breast implants.

During the exam:

When you’re ready for the mammogram itself, you’ll head to a private dressing room, remove your clothing and change into a gown or robe that will open from the front. You will be assigned a locker to store your things. In the exam room, prior to imaging, the technician may apply nipple or scar markers on your breasts as required by the radiologist. The technologist will position your breast on the mammogram machine and compress your breast briefly to obtain the image. Compression is important because it will smooth out the breast tissue so as not to obscure any areas. This is repeated in a different position and angle for a total of two views per breast.

If you are having a diagnostic mammogram, you will still have the same two views of each breast as well targeted views of the area of concern. The radiologist will review the first set of images taken and may ask the technologist to take additional views which may be followed by a breast ultrasound.

Will it hurt?

There’s no sugarcoating it: mammograms can be uncomfortable. Your breasts are being squeezed by a machine, and many women don’t find the sensation particularly pleasant. The good news is the compression itself lasts only for a moment or two, and the ensuing discomfort is temporary.

If you are worried, speak with your healthcare provider about whether you can take an over-the-counter pain reliever, such as aspirin, acetaminophen or ibuprofen, an hour or so before the screening. During the mammogram, let your technician know if the pain is too much to bear; they can adjust as needed.

How long will it take?

“A screening mammogram takes very little time and a woman can expect to have a procedure that typically lasts less than 45 minutes. Some women are in and out in 10 minutes. It all depends on the patient’s type of breast tissue, breast mass and the size of breasts,” says Dr. Boatsman.” Regardless of these factors, your breasts are compressed for only a brief period of time. Between travel, registration paperwork, answering history questions, undressing and the imaging itself, he recommends blocking about two hours out of your schedule for the whole process, though it generally takes less time.

Because of COVID-19, we screen all patients prior to entry and check temperature. Additional cleaning measures are in place between patients and due to social distancing we may ask you to wait in your car until we are ready for you.

When should I get my results?

Once you’ve completed your mammogram, a radiologist who is a specially trained physician in the area of diagnostic imaging, will interpret your exam and compare it to any previous mammograms you may have had in order to detect any changes. The radiologist will then create a report that will go to your referring healthcare provider.

A written summary of mammogram results must be delivered within 30 days, according to U.S. law, although typically, it’s faster than that. “In our office the results come back within two to three business days,” says Dr. Boatsman. Sometimes, if a radiologist is on hand, you can learn your results during your appointment. If the radiologist finds something to suggest cancer is present, they must make an effort to provide results as soon as possible.

Reach out to your HCP or imaging center if you don’t hear back after 10 to 14 days. Never presume that your results are normal. Someone must tell you that’s the case.

What are the next steps?

If your mammogram is normal, continue to be screened as directed by your doctor. Between screenings, speak with your HCP if you notice any changes in the look or feel of your breasts.

Abnormal results will likely entail additional testing, so your HCP can figure out whether cancer is present. This can involve a diagnostic mammogram, a breast ultrasound or a breast MRI. If cancer is suspected, a breast biopsy will be needed for confirmation.

“Being called back in for additional imaging results in anxiety for quite a few patients,” says Boatsman. It’s important to remember that callbacks are common, and the vast majority of those patients brought in for further tests do not have cancer. The technician may simply need clearer images. Or, if you have dense breast tissue, it can make mammograms tougher to assess. Either way, the follow-up will provide some answers. Typically, you’ll get imaging results during the appointment, but biopsy results can take a few days.

Don’t delay your annual screening. Schedule your mammogram today.

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