Ah, the wonderful mammogram -- lifting your breast onto metal plates (brrrrr!) only to have it squashed and X-rayed is about the last thing any of us wants to do. Topless, vulnerable, surrounded by strangers and scary medical equipment -- somehow a Pap smear seems less invasive.

But in truth, our imagination makes mammography so much worse than it really is. Judy Drainville, assessment coordinator for the Ontario Breast Screening Program for North Western Ontario, says most women remark, "That's it?" when it's all over. "Mammograms shouldn't be a big deal," she says. "The test is simple. The expectation far exceeds the event."

Why don't women go?
Dr. Verna Mai, director of screening programs for Cancer Care Ontario, says Statistics Canada found three common reasons women didn't go for their mammogram:
• They didn't know it was necessary;
• Their doctors didn't recommend one, so they didn't think they needed it;
• They just hadn't gotten around to it.

Drainville says many women fear something will be detected, even though catching breast cancer early is your best bet for survival. Many women also don't bother scheduling their mammogram because they think there is pain involved. "Women think it's going to hurt, and we need to dispel this fear," she says.

Who needs to go?
There is no universal mammography standard, but the Canadian Breast Cancer Foundation recommends a mammogram for women between the age of 50 and 69 done at least every two years.

If you're under 50 or think you might have an elevated risk (family history of cancer, previous breast disorders, etc.), talk to your physician about how often you should have screening done.

Dr. Donald Henderson, radiology coordinator for the Ontario Breast Screening Program for North Western Ontario, warns that risk factors rarely determine who gets breast cancer. "Keep in mind even if you do not have an elevated risk, 90 per cent of all breast cancers are sporadic. Women [over 50] with no known risk factors still should have regular mammography," he says.

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Easy-breezy mammography
Knowing what to do before, during and after your mammogram will make it a worry-free experience. Here are a few tips and helpful hints:

Before
• Schedule your mammogram for one week after your period, when your breasts are less sensitive.

• Although perfume is okay, don't wear deodorant, talc or powder -- it can interfere with the mammogram and show up on the image.

• Wear a comfortable, front-opening two-piece outfit. You may need to remove everything from the waist up and wear a hospital gown.

• Drainville suggests having a look at where you're going to have your mammogram done. "Choose a facility that is CAR [Canadian Association of Radiologists]-accredited. This means everyone -- from the machines to the technologists to the radiologists -- has met CAR criteria," she says. CAR-accredited facilities are checked and recertified every three years.

To contact CAR and inquire about an accredited facility near you, visit their website.

During
• A technologist will help to place your breast between two plates (the mammography plates) and will use compression to "flatten" the breast for the best possible image. Two pictures of each of your breasts will be taken at different angles -- one from top to bottom and the other from side to side.

• Be prepared to talk to the technologist -- they're there to help you. "If you're nervous, tell them you're nervous. Tell them you don't know what to expect," says Drainville. Dr. Henderson adds the technologists work strictly with mammograms and nothing else. "They are very good at explaining the procedure and understand your concerns," he says.

• The radiologist needs a good, clear picture of your breast tissue. "Make the most of your decision to have a mammogram: allow for a little compression and hold still," says Dr. Mai.

After
• In most provinces, a letter with the results of your mammogram and your clinical breast examination is sent both to you and your family physician. You can expect to get your letter about two weeks after your mammogram.

• If you have had an abnormal exam, you will be notified with a follow-up procedure. "Ten per cent of women require a follow-up. This is not unusual. Ten per cent of this 10 per cent will be a cancer," says Drainville.

• If it was your first mammogram, you may also be notified for a follow-up as a precaution since there was no previous mammogram to compare your results with.

• If you haven't heard anything after two weeks or don't know what to do, contact someone at your breast screening facility.

And note that mammograms have proven to reduce breast cancer mortality far beyond manual clinical exams and breast self-examinations.

To make it easy, become part of an organized screening program in your province. They will remind you of your next screening and will help to track your medical records. Ask your doctor about becoming a part of an organized breast screening program in your province or territory.

Read about 12 simple lifestyle changes you can make now to help prevent breast cancer.

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