Getting a mammogram is straightforward: you can call a local imaging center or hospital radiology department and schedule one directly, often without a doctor’s referral. Most insurance plans cover screening mammograms at no cost to you. The whole appointment takes about 20 minutes, and results typically arrive within a few weeks.
Do You Need a Doctor’s Referral?
For a routine screening mammogram, many facilities allow you to book without a prescription or referral. Medicare, for example, does not require a doctor’s order for screening mammography coverage. Many states also have self-referral laws that let you schedule directly at any certified mammography facility.
That said, some individual imaging centers or hospital systems still ask for a referral as part of their own intake process, even when it’s not legally required. If you have a primary care provider, asking for an order during a regular visit is the easiest route. If you don’t, call the facility first and ask whether they accept self-referrals for screening mammograms. Planned Parenthood locations, community health centers, and breast health clinics frequently offer screening without a referral.
When to Start and How Often
The U.S. Preventive Services Task Force recommends that all women begin screening mammograms at age 40 and continue every two years through age 74. This applies to people at average risk for breast cancer. If you have a family history of breast cancer, a known genetic mutation, or other risk factors, your provider may recommend starting earlier or screening annually instead of every other year.
What Insurance Covers
Under the Affordable Care Act, all Marketplace health plans and most other insurance plans must cover screening mammograms for women 40 and older every one to two years with no copay, coinsurance, or deductible. This applies as long as you use an in-network provider, so check your plan’s provider directory before booking.
If you’re uninsured or underinsured, the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) offers free or low-cost mammograms. You may qualify if your household income is at or below 250% of the federal poverty level, you’re between 40 and 64, and you lack insurance that covers screening. Every state runs its own version of this program, and you can find yours through the CDC website or by calling 211.
How to Prepare for Your Appointment
Preparation is minimal, but a few details matter. Skip deodorant, antiperspirant, powders, lotions, creams, and perfumes on your breasts and underarms the day of the exam. Metallic particles in these products can show up on the images and be mistaken for abnormalities. Wearing a two-piece outfit makes things easier since you’ll need to undress from the waist up.
If you’ve had mammograms at a different facility in the past, try to have those images transferred before your appointment. Radiologists compare current and prior images to spot changes, and having your history available reduces the chance of being called back for additional views. Most facilities can request records electronically if you provide the name and location of the previous center.
If you find breast compression painful, scheduling your mammogram for one to two weeks after your period starts can help. Breast tissue tends to be less tender during that window. You can also take an over-the-counter pain reliever about an hour beforehand.
What Happens During the Exam
You’ll change into a gown and stand in front of the mammography machine. A technologist positions one breast at a time on a flat platform, then lowers a clear plastic paddle to compress the breast. Compression spreads the tissue so the X-ray can capture a clearer picture, and while it can feel uncomfortable or briefly painful, each compression lasts only a few seconds. Two images of each breast are standard for a screening exam: one from top to bottom and one from side to side.
The entire process typically takes 10 to 20 minutes. A radiologist reviews the images after you leave, so you won’t get results at the appointment itself.
2D vs. 3D Mammograms
Most modern facilities offer 3D mammography (also called tomosynthesis), which takes multiple thin images of the breast from different angles. Compared to traditional 2D mammograms, 3D mammograms detect cancer more easily and produce fewer false positives, meaning you’re less likely to be called back for a scare that turns out to be nothing. The radiation dose is slightly higher than 2D but still considered safe. Many insurance plans now cover 3D mammograms at the same rate as 2D, though it’s worth confirming with your insurer beforehand.
Screening vs. Diagnostic Mammograms
A screening mammogram is a routine check when you have no symptoms. A diagnostic mammogram is ordered when something needs a closer look: an abnormal screening result, a lump you or your doctor found, nipple discharge, or breast pain. Both use the same machine and the same compression technique, but a diagnostic exam takes more images from additional angles and may include magnified views or ultrasound.
Diagnostic mammograms are also used for people with breast implants, since implants can obscure tissue on a standard screening exam. Insurance coverage for diagnostic mammograms may involve a copay or deductible, unlike the free coverage for routine screenings.
When You’ll Get Results
Federal law requires mammography facilities to send you a written summary of your results in plain language within 30 calendar days of the exam. Many facilities are faster, posting results to an online patient portal within one to two weeks. If the results are suspicious or highly suggestive of a problem, the facility must notify you within seven calendar days.
Your results letter will include a breast density classification. As of September 2024, FDA rules require every mammography facility to tell you whether your breast tissue is dense or not dense. About half of women who get mammograms have dense breasts. Dense tissue makes cancer harder to spot on a mammogram and is itself a risk factor for breast cancer. If your results say your tissue is dense, your provider may recommend supplemental screening with breast ultrasound or MRI.
Understanding Your Results
Mammogram results are classified on a scale from 0 to 6. The numbers you’re most likely to see on a screening result are:
- Category 0 (Incomplete): The radiologist needs more information. This usually means you’ll be called back for additional images, magnified views, or an ultrasound. A callback does not mean cancer. It often means tissue overlapped in the image or a small area wasn’t captured clearly.
- Category 1 (Negative): No abnormalities found. You’ll return for your next routine screening in two years.
- Category 2 (Benign): Something was seen, like a cyst or calcification, but it’s clearly not cancer. This is still considered a normal result.
- Category 3 (Probably benign): A finding that has no more than a 2% chance of being cancer. Your provider will likely recommend a follow-up mammogram in 6 to 12 months to confirm the finding stays stable.
Categories 4 and 5 indicate increasing suspicion and typically lead to a biopsy. Category 6 is used when cancer has already been confirmed. The vast majority of screening mammograms come back as category 1 or 2. About 10% of people are called back after a screening mammogram, and of those, most turn out to have benign findings.