DEAR DOCTOR K:

I just scheduled my first mammogram. What can I expect during the procedure?

DEAR READER:

Unfortunately, I can't tell you from personal experience. I know what every doctor knows, but only a person who has undergone a medical procedure firsthand really knows what it's like.

A mammogram is an X-ray of the breasts, to look for breast cancer. Mammograms can identify breast cancer at a very early stage when it is most easily treated and is not life-threatening. Mammograms can also help clarify whether a suspicious breast lump is cancerous or not.

Mammography is quick and generally painless. It usually takes less than 30 minutes.

On the day of your mammogram, avoid using deodorants, lotions or other products on your breasts or under your arms. These products may be mistaken for signs of breast disease on the mammogram.

When you arrive at the X-ray facility, you will need to remove your clothing from the waist up. You will be given a hospital gown to wear during the test.

Each of your breasts is X-rayed separately. You are asked to hold your breath for a few seconds while each X-ray is taken. When you breathe, your chest moves, and that moves your breasts. Movement of the breasts blurs the X-ray picture.

For some X-ray views, your breast is compressed briefly between two plastic plates. This is somewhat uncomfortable, and many of my patients tell me these plates feel very cold. But the test should not be painful. Compressing the breast spreads out the breast tissue. It provides a clearer image of the thicker areas of your breast.

If you have breast implants, tell the X-ray technician. Breast implants affect the way your mammogram is performed and analyzed.

Don't be alarmed if something on your mammogram requires additional testing. This is not unusual, and most abnormalities are not cancerous. In fact, around 90 percent of the abnormalities seen on mammograms turn out not to be cancer. This is called a "false positive" result. That means that regular mammograms produce a period of what proves to be unnecessary worry in nine women for every one woman in whom the mammogram spots a true cancer. Doctors are working hard to improve mammograms, or to find other tests that are more accurate.

Most testing facilities will immediately take different, larger images of the area in question. Sometimes a doctor may order a fine-needle biopsy of the suspicious spot. Breast cells will be removed with a needle and sent to a laboratory to determine if they are cancerous.

After your mammogram, you can get dressed and return to your normal activities. These days, the radiologists at many mammogram facilities tell you pretty quickly what the result shows. In some communities, the radiologist reports the result to your primary care doctor, who then lets you know the result. If you don't get a report from the people who did the mammogram, check with your doctor for your test results after a few days.

Mammograms are like some other medical tests: not entirely pleasant, but really important for your health.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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