Preparing For a Mammogram, by Aarti Patel & Terri Fleming
Preventative health screenings are some of the most important steps you can take to care for your body. While breast cancer is the most common cancer among women, there are effective screening methods, like a mammogram, to detect breast cancer early. All people (regardless of sex assigned at birth) have breast or chest tissue and could potentially be diagnosed with cancer in this tissue. We know that the risk of breast cancer is much higher in people who were AFAB (Assigned Female At Birth).
Your decision on when to have a screening mammogram should be based on your personal values, family history, genetic risk factors, and shared decision making with a provider you trust. It is recommended to start this conversation at least by age 40.
A mammogram is an x-ray image of your breast/chest tissue.The x-ray machine has two plates that compress and flatten the breasts/chest to give a better image of your breast/chest tissue. This is often the most uncomfortable part of the exam and usually lasts between 20-30 seconds. We’ve created a list of tips that can be shared with anyone preparing for their mammogram.
If you’re feeling anxious before a mammogram, you’re not alone! Give yourself the space to acknowledge your emotions. If this is your first time, share those feelings with a friend who may have had one to learn from their experience.
You’re in control: It’s common to feel discomfort during the compression part of the exam, but if it’s making you really uncomfortable, let the technician know and they can adjust the settings. You can also take an ibuprofen one hour before the exam to help with the pain.
Schedule the test when your breasts/chest aren’t tender: Your breasts/chest can be tender right before and during your period. To prevent any unnecessary discomfort, schedule around your menstrual cycle.
Skip the deodorant: They can sometimes appear as little white dots on the x-ray that look like calcifications.
Work with the x-ray technician: Maybe you felt a new lump? Let the technician know so they can try to get the best image possible of that area.
Family History is key: If you have a parent, an aunt, or grandmother who’s been diagnosed with breast/chest cancer, you may need to start getting mammogram screenings earlier.
Not all breasts/chests are the same! Some people may have dense breast/chest tissue which could reduce the accuracy of a mammogram. A 3D mammogram may be recommended to supplement your mammogram. This should be a conversation with a provider you feel comfortable with. Learn more about dense breast/chest tissue here.
Mammograms are a great initial screening test, but it’s important to know that it may not find every cancer. It will also find things that prove not to be cancer. It’s helpful to think of mammograms as part of our general breast/chest health and preventative care practices.
We at Womanly realize that awareness for breast/chest cancer is very centered on cisgender heterosexual women and the following is more information for transgender and non-binary individuals in regards to breast/chest cancer screening.
Guidelines are not as clear for breast/chest cancer screening in the transgender community due to limited research. Fenway Health, a major LGBT health organization, provides some guidance for patients and providers.
Transgender Women:
A lot of transgender women have dense breasts which is a risk factor for breast/chest cancer and predictor of increased rates of false negative mammograms. If you need additional screening your health care provider will be alerted.
Transgender women over the age of 50 who has used feminizing hormones for more than five years are advised to get mammograms yearly. If you have a family history of breast/chest cancer talk to your health care provider earlier than this age.
Transgender Men:
Excess testosterone in the body can be converted to estrogen and estrogen increases risk of breast/chest cancer.
After top surgery some chest tissue will remain and your healthcare provider may advise a chest wall and axillary or under the armpit exam and screening. Chest wall exams should begin around age 50 and may require a mammogram with shared decision making with your provider. If this is uncomfortable, a self- examination may be helpful. Remember to always consider family history of breast/chest cancer as it may be recommended to screen earlier.
If you have not had top surgery, it’s important to follow the recommended guidelines for the breast tissue screening.
It is recommended to have an open and honest conversation with your provider on what is right for you and your body.
We are discussing screenings but if you feel any lumps or bumps in your chest or underarm area it is important to ask a provider right away.
Resources:
Breast Cancer Risk Assessment Calculator
US Dept of Health & Human Services Mammogram Search
National Breast Cancer Foundation Free Mammogram Affiliations