Should Young Women Get Mammograms?

We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful women's health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions remain anonymous. This week’s topic: what getting a mammogram is like.

Q: I just saw a new doctor, who said that it’s time for me to start getting routine mammograms because breast cancer runs in my family. I thought I wouldn't have to deal with that until I was older! I know that it’s a procedure for checking if you have breast cancer, but I’m not really sure how it works. Does the machine smush your breasts to feel lumps? Do mammograms hurt? And how often do I need to do it?

A: When you reach a certain point in your life, it’s a good idea to start getting screened for breast cancer. But younger women with a family history of breast cancer or the BRCA1 or BRACA2 gene may also need to get checked routinely. You can check yourself out with routine breast self-examinations, but the most efficient way to check in with the girls is to get a mammogram — research has found that getting screening mammograms helps reduce breast cancer deaths.

Here's everything you need to know about them.

What Exactly Is A Mammogram?

A mammogram is a procedure where you get an x-ray of your breast. This results in a bunch of black and white images that your radiologist will look at to see if there are any signs of cancer. Specifically, an x-ray machine shoots a small amount of radiation through your breast. Your body parts absorb the x-rays more or less depending on their density, with bone absorbing most of the rays and soft tissue allowing more to pass through. In this way, the x-rays record the image of what it’s seen on a detector on the other side — so your doctor can see inside you.

There are two types of mammograms: Screening mammography is when you get a mammogram to see if you have any unseen changes in your breasts that could indicate cancer. Diagnostic mammography is when you’ve already noticed a change in your breasts and want to check out if these changes are potentially cancerous. This second type takes a bit longer because you need to get more x-rays done at different angles to check on a specific area of concern.

What Does It Look For?

The little x-rays wiggling their way through your breasts when you get a mammogram are looking for indications of cancer. This can include tumors or lumps, and microcalcifications (which are tiny calcium deposits that can indicate the presence of cancer nearby).

What Do I Need To Do Before My Mammogram Appointment To Prepare?

It’s important to bring any previous mammogram images you’ve gotten in the past — this is because much of what doctors look at when they’re checking out your mammogram images is any change from the last time you got one.

You also will want to remember not to put on deodorant. While you may think you’re being nice to the radiology technician (the person who takes the x-rays) by wrangling your natural scent, you could actually be messing with the mammogram images you get, because deodorant particles can get into the image.

What Will Happen Right Before My Mammogram?

Getting a mammogram is an outpatient affair, so you can walk in and walk right out again when you’re done. Once you’re in the room where you’re going to get your mammogram, you’ll strip to the waist, including all your necklaces, and put on a gown. Your doctor will ask you to tell her your medical history, and if you’re there because you have any potential symptoms of breast cancer, she’ll ask you more questions about that specifically. If you have a lump you already know about, she might tape a little marker over the lump.

What's It Like To Get A Mammogram?

When you actually get your mammogram, the radiology technician will put one of your breasts in the mammography unit, which is a rectangular box that has the x-ray equipment in it. This box makes sure that the x-rays are only hitting your breast, so that radiation to your body is minimized (more on why that’s important later, in the risks section below). Over the box is a plastic paddle that keeps your breast in place and compresses it gently for a few seconds.

Your radiology technician will position you in a couple of different positions so she can get some different angles — generally she’ll take two of each breast, but if you’re particularly stacked or have breast implants, you may get more, and the same goes for if you’re getting a diagnostic mammogram, because the technician will be drilling down to a specific section of your breast. Each time the x-ray is about to be taken, she’ll ask you to stay very still and hold your breath, so you don’t blur the picture. Overall, the whole process will take you about 30 minutes.

Will It Hurt?

Why do you need to be smushed? Good question. Compression evens out the thickness of your breast so that the mammography unit can “see” all of your breast tissue. This makes it more likely that any abnormalities will be visible in the images. Thinning out the breast tissue also means that a lower dose of x-ray can be used to go through the breast, because it’s, well, thinner. The paddle helps to keep you still so that your picture won’t be blurry.

Compression can be uncomfortable for people with sensitive breasts, but the procedure isn’t supposed to be unbearable. In fact, research shows that most people (72 percent in fact) characterize mammograms as only mildly painful — at most, akin to a small headache or wearing shoes that are one size too small. And remember that each smush only lasts a couple of seconds. If you have more tender breasts generally or your breasts are fibrocystic, which is the technical term for lumpy, you may experience more discomfort. If you know this about yourself, tell your radiology technician beforehand so she can handle you more gently, and also definitely let her know if you're feeling pain during the actual mammogram, so she can make changes to make you more comfortable.

There are some things you can do to minimize compression pain. For instance, you can schedule your mammogram for when your breasts aren’t super tender, which is the week after you end your period for most people. You can also take an over-the-counter pain medicine like aspirin or ibuprofen before you go in for your appointment. Also, some people find that their breasts feel more tender after they each chocolate or caffeine, so you may want to avoid those the week before you get your mammogram. Finally, it helps to relax during the actual procedure. When you're stressed, your chest muscles are too!

How Long Will It Take To Get My Results?

The person who shoots x-rays through your tits in a feat of futuristic science is not the same one who is trained how to look at them and tell what they actually mean. That job of interpretation falls to your radiologist. She’ll check out your images and then you’ll get your results either from her or from your doctor who ordered the mammogram. Getting your results shouldn’t take that long, so if it’s been a few days since your breasts got smushed, call up your doctor to check in.

What If I Have Breast Implants?

It’s important for all people with breasts to get mammograms — even if the breasts in question have been augmented. If this is you, definitely let the people doing your mammogram know, because it requires a slightly different skill-set and you want to make sure you’re getting the care you need. Breast implants can cover up some of your breast tissue, which can make abnormalities harder to notice.

If the reason why you have a breast implant is that you’ve already had breast cancer and have had your breast removed (which is called a mastectomy), ask your radiologist if you need to keep getting mammograms on your new breast.

Do Young Women Need To Get Mammograms?

When you should start getting mammograms depends on a couple of factors. If you don't have any family history of breast cancer, the American Cancer Society says that you should get your first mammogram at age 40, and every year after. The U.S. Preventive Services Task Force says you can wait until age 50. This is confusing, but most people agree with the 40 start time.

If you do have a family history of the disease (or you have the BRCA1 or BRACA2 gene), it's recommended that you start getting screening earlier in life — sometimes as early as age 25 but definitely by the time you're 30. Talk to your doctor about coming up with a plan for when to start and how often you should get mammograms.

Are There Health Risks To Getting Mammograms?

You may have noticed before this point that mammograms involve x-rays, which are radiation. The biggest risk associated with getting a mammogram is the small amount of radiation that gets shot into your body. This is counter-intuitive, since radiation causes cancer, right?

Yes, but the amount of radiation that makes it into you is extremely low — so low in fact that catching your breast cancer is deemed more beneficial than the risk of getting cancer from the procedure and is approved by all the necessary regulatory bodies. However, it can be dangerous to your fetus if you’re pregnant, so make sure to tell your doctor if you’re eating for two. Overall though, radiology technicians make sure to use the lowest radiation dose they can to make sure you’re protected.

Does An Abnormal Mammogram Mean Cancer?

If you get an abnormal mammogram, that doesn’t mean you have cancer. Most of the time, a spot found on a mammogram is not cancerous. The next step for any potentially abnormal mammograms is to get a biopsy, to see for sure if cancer is actually present. This is when your doctor removes a piece of your breast tissue and checks it out under the microscope to see if it has cancer cells in it.

Basically, a certain subset of mammograms think they’ve found something that they haven’t actually. This is called a false positive mammogram, in which you experience the extremely stressful situation of thinking you have breast cancer for a bit of your life. Unfortunately, this is pretty common — if you start having a yearly mammogram at age 40, by the time you’re 49 there’s a 30 percent chance you’ll have gotten a false positive mammogram. This is more stressful and annoying than anything else. The confirmatory biopsy you’ll get after you get your mammogram results will clear it up.

Do Mammograms Ever Fail To Catch Cancer?

On the flipside, you could get a false negative result, in which the mammogram doesn’t catch a cancer you have. This happens in around 20 percent of instances, and occurs particularly with people who have denser breasts (because it has the same density as a tumor, so it can be hard to differentiate). You’re more likely to have dense breasts when you’re younger, so this happens more often in younger people. There’s not much to be done about this problem at this point in time, but scientists are working on newer and better technology that can catch more instances of cancer earlier. This is yet another reason why self-exams are so important!

The Bottom Line

Getting an uncomfortable test every year can be annoying, and when things are annoying, sometimes people don’t do them — even though we know they are good for us. Humans are complex creatures and sometimes we work against our own best interests! But in the case of mammograms, the importance is clear.

While the procedure isn’t perfect (it doesn’t catch everything, sometimes it thinks it’s caught something and freaks you out and then it was wrong and it’s not alive so it can’t even apologize), they are the best thing we’ve got right now. And the bottom line is that they do save lives. So when your doctor tells you it’s time to start squishing your breasts into a metal box, take a deep breath — and go for it.

Images: Bianca Consunji/Bustle; Ben Ostrowsky/Flickr; Giphy