Breast Health Program

The National Comprehensive Cancer Network, American College of Radiology and Hoag Breast Program recommend annual mammograms starting at age 40 as the standard of care for most women. We encourage you to personalize your screening program with your physician and learn your risk factors. If you are at high risk for breast cancer, consult with your physician about whether you should begin screening before age 40 and how often you should be screened. Additional screening measures may also be appropriate for some women, such as whole breast ultrasound and MRI.

Consider scheduling your mammogram during the second week of your menstrual cycle (one week after your period) when your breasts aren’t likely to be tender or swollen. If your menstrual cycle is irregular or cannot be accurately timed for other reasons, simply schedule your screening mammogram at any time.

The National Comprehensive Cancer Network (NCCN), the American College of Radiology (ACR) and the American Society of Breast Surgeons (ASBrS) all recommend yearly mammograms for women starting at age 40.

Screening mammograms are usually completely covered by insurance (without a co-pay) once every year (note: this does not apply to diagnostic mammograms performed for symptomatic patients). Usually, you do not need a referral for a screening mammogram if you’ve seen your primary care physician within the last 12 months and you are over 40 years old. If your physician provided you with an order for your mammogram, please email your order to orders@hoag.org, or bring a copy to your appointment.

Hoag’s dedicated, fellowship-trained breast radiologists will compare your previous breast images with your new images for optimal accuracy. The ability to compare current and prior images improves both the detection of subtle abnormalities, as well as reducing the need for additional diagnostic imaging to evaluate asymmetric tissue changes that may have been stable for many years.

If you’ve had prior mammograms at Hoag, your records are on file as part of your medical record. If your most recent breast imaging was performed at a non-Hoag facility, please have your records (images and reports) sent to Hoag before your mammogram or bring your records on a CD/DVD to your appointment. If we do not have your prior images at the time of your exam, we can request them for you, however your mammography results may be delayed as a result.

Please do not wear perfume, deodorant, creams, lotions or powders between your neck and waist. These products contain ingredients that may affect the interpretation of the mammogram. Children under the age of 12 may not accompany you to the exam room and cannot be left unattended.

We suggest wearing a two-piece outfit (separate top and bottoms) instead of a dress or jumpsuit because you will be asked to undress from the waist up. At Hoag, we will provide you with a comfortable robe.

If your physician provided you with an order for your mammogram, please email your order to orders@hoag.org, or bring a copy to your appointment.

During your mammogram, your Hoag technologist will talk you through the procedure and position your breasts one at a time in between imaging plates. You will feel gradual pressure on your breast. This pressure is needed to achieve the clearest images possible, but each image only takes 2-4 seconds.

Typically, two pictures of each breast will be acquired, but your technologist reviews each image to ensure adequate coverage and quality, and she may recommend additional images to ensure the best exam possible. If you have breast implants, images will be taken with and without the implants in view. The images with the implants in view involve little or no compression.

For most women, mammography is not painful, although some women may experience minor discomfort. If you experience discomfort, please inform your technologist and they can adjust the pressure.

Once the mammogram is complete, a dedicated Hoag breast radiologist will carefully interpret your mammogram images, typically the next business day. Soon after, a written report with your mammogram results will be available in your electronic medical record system or as a mailed letter. We will also send a copy to your indicated primary care provider.

In addition to your mammogram results, your report will inform you if you have dense breasts. Learn more about breast density. Additionally, based on your responses to the Hoag Early Risk Assessment, your results will indicate if you have an average or elevated risk of developing breast cancer. If you have an elevated risk, learn more about our Hoag’s High-risk Breast and Ovarian Cancer (HBOC) Prevention Program.

If the radiologist has recommended additional imaging, a Hoag staff member will call you within 24-48 hours. This additional imaging step typically involves a diagnostic mammogram and/or a breast ultrasound exam, and it is designed to provide you and your breast health team with important information that will be evaluated to clarify, supplement, or confirm the findings of the initial screening mammogram. On the day you return, one of our breast radiologists will go over all of your results in detail at the conclusion of the exam. Rest assured that most people who are recalled for additional imaging will not need a biopsy. It is somewhat more likely to be recalled after the first mammogram (or if your prior mammograms are not attainable) because the radiologist does not have prior studies to which they can compare the images.