What is a mammogram? A mammogram (also called a mammography exam) is a safe, low-dose x-ray of the breast. A high-quality mammogram is the most effective tool for detecting breast cancer early. Early detection of breast cancer may allow more treatment options. It could even mean saving your breast or your life. When should I have a mammogram? Talk with your doctor about this. Your risk for breast cancer increases as you get older, so you need to be on a regular schedule for mammograms. Generally, if you are in your 40s or older, having a mammogram every 1 to 2 years could save your life! However, when and how often you have a mammogram is something you need to decide with your doctor, who will consider your breast cancer risk in recommending a mammogram schedule for you to follow. How can I be sure I'm getting a high-quality mammogram?

The Mammography Quality Standards Act (MQSA) is a federal law that makes sure every mammography facility meets quality standards. Mammography facilities include breast clinics, radiology departments in hospitals, mobile vans, private radiology practices, and other doctors' offices. The Food and Drug Administration (FDA) ensures that facilities all around the country meet MQSA standards. These standards apply to the following people at your facility:

• the technologist who takes your mammogram,
• the radiologist who studies your mammogram, and
• the medical physicist who tests the mammography equipment.

To work in mammography, all of these professionals must have special training and education. In addition, because technology is always improving, these people must keep up with any changes through ongoing education. MQSA also makes sure that mammography equipment is tested regularly and maintained to operate properly. Look for the MQSA certificate displayed at your facility and check its expiration date. This certificate means that your facility has to undergo regular inspections and should provide you with a high-quality mammogram. If the expiration date has passed, tell facility staff. It's good to know that FDA protects me by regularly inspecting my facility. What happens if problems are found during an inspection?

Most facilities practice high-quality mammography and pass their inspections. If a problem were found during an inspection, the MQSA inspector would tell the facility what needs to be corrected so that it can pass inspection and continue to provide high-quality mammograms. Minor problems found at a facility often can be easily fixed.

Rarely, an inspector finds a more serious problem that could affect the quality of mammograms and their results. If this happened with your facility, for example, your facility or FDA would contact you and your doctor and suggest what you should do. You may need to have your mammogram repeated. Look for the MQSA certificate at your mammography facility. The certificate means that the facility has to undergo regular inspections to meet quality standards. This information gives me confidence about the quality of my facility. How else does MQSA help me? The law also aims to improve communication between you and your facility. As a result of MQSA, your facility must:

• ask if you have breast implants before performing your mammogram,
• send you your mammogram results,
• transfer your original mammograms upon your request to you or to a facility or doctor you specify, and
• address your concerns.

From the time you make a mammogram appointment to the time you get the results, you should understand what is happening and be sure that your questions are answered. The more you know, the better you can care for your own breast health.

What if I have breast implants?

When you call your facility to schedule a mammogram, tell them that you have breast implants. If your facility doesn't accept patients with implants, ask if they can give you the name of a facility that does. When you arrive for the exam, remind facility staff you have implants and will need a technologist trained in x-raying patients with implants. This is important because breast implants can hide some breast tissue, which could make it difficult for the radiologist to see breast cancer when looking at your mammograms. If the technologist taking your mammograms knows you have implants before performing the exam, she will make sure that as much breast tissue as possible can be seen on your mammograms.

How will I get the results of my mammogram?

Your facility will give you the results of your mammogram in easy-to-understand language. It will give you these results at the time of your appointment or may choose to mail the results. If mailed, the letter containing your results must be sent within 30 days of your mammogram. The facility also will send your doctor a medical report of your mammogram results.

I thought "no news was good news." Wouldn't my doctor let me know if there was a problem?

Although the results of most mammograms are normal, don't assume that no news means that there are no problems. It is very important that you get the results of your mammogram. If you don't receive them within 30 days of your mammogram, call your mammography facility or doctor and ask for them.

If I don't have a doctor, who receives the medical version of my report?

In this case, your facility will send you both reports of your mammogram results--the version in easy-to-understand language and the medical version. If your facility thinks you should see a doctor, its staff will let you know and can recommend one.

If I change facilities or need a second opinion, do I need my mammograms?

Good question! The answer is yes, but be sure they are originals--not copies. By law, you are entitled to your original mammograms. A doctor needs to compare past mammograms with current ones to see if there have been any changes, and original mammograms are needed for this comparison. Ask your facility for your original mammograms and for a copy of the medical version of your report. You will probably be asked to fill out a form to release your medical records. You can ask the facility to send your records to another medical facility, to your doctor, or to you. Your facility may charge a fee for this service. If they do, the fee must not be more than the cost of providing this service to you.

I am on a regular schedule for mammograms and I do monthly breast self-exams. What if I notice a change in my breasts?

Although mammograms are very effective, they don't find all breast problems. If you find something unusual in either breast during your monthly breast self-exam (such as a lump, a thickening, or discharge from a nipple), call your doctor immediately. When checked, many breast changes are not cancerous--but only your doctor can know for sure.

What if I have a concern about my exam or facility?

If you have a concern about your exam or facility that you think could affect your health, follow these steps:

• Talk with a facility staff person. If he or she can't help you, you will be told who on their staff can address your concerns.
• If the facility cannot resolve your concerns, ask for the name, address, fax number, e-mail address, or phone number of the contact person at your facility's accreditation body to contact about your complaint. Be sure to provide them with your name, address, and phone number. (Note: The American College of Radiology requests that all complaints to them be in writing; State accrediting bodies will also accept phone calls.) The name of the accreditation body is on the MQSA certificate displayed at your facility.
• If your facility's accreditation body doesn't resolve your concerns, write to FDA at:
  
  Center for Devices and Radiological Health
  Office of Health and Industry Programs
  Division of Mammography Quality and Radiation Programs
  (HFZ-240)
  Rockville, Maryland 20850
  Or call 1-800-838-7715.

Where can I find out more about mammography?

• Talk with your radiologist, technologist, or doctor.
• Call the National Cancer Institute's (NCI's) Cancer Information Service at 1-800-422-6237 for answers to questions, or to locate an FDA-certified mammography facility near you. Their specially trained staff can provide up-to-date information in English and Spanish. People with TTY equipment should call 1-800-332-8615.
• Check out FDA's mammography website at www.fda.gov/cdrh/mammography.
• Visit FDA's Office of Women's Health website at www.fda.gov/womens/default.htm.

Be informed!  Get involved!  Be sure that you....

Look for the MQSA certificate at your facility and check its expiration date.  Tell facility staff it your have breast implants when scheduling your appointment.  Make sure you receive your mammogram results.  Tell your facility about your concerns.  When needed, obtain original mammograms.

Be informed! Get involved! Be sure