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Frequently Asked Questions about Breast Care and Mammograms

Breast care is an important part of health and wellness for women. At Memorial Hermann, we are dedicated to providing exceptional care, with high-quality breast exams and screening procedures. Each woman is unique, and breast-care needs change during different stages of life. The physicians at Memorial Hermann can help determine which exams are right for you.

Two important parts of breast care are breast self-exams and clinical breast exams. The earlier that breast abnormalities are found, the better. Having regular exams is the best way for you and your health care provider to detect problems early, when treatments are most successful.

Breast Self-Exams

A breast self-exam is an inspection that you do yourself. By using your own hands and eyes, you can examine your breasts to search for changes in how they look and feel. When you do self-exams on a regular basis, you will become familiar with your breasts and will be able to notice changes more easily.

It is a good idea to examine your breasts each month, beginning at around 20 years of age. If you menstruate, examine your breasts after your period ends, when your breasts are likely to be less swollen and tender. Postmenopausal women should choose one day of the month, and consistently perform self-exams on that day.

What to Do:

Start with a visual (with your eyes) exam. First, remove all clothing above your waist, and then sit or stand in front of a mirror with your arms at your sides. Look for changes in breast size or shape, as well as any signs of dimpling, puckering, redness, or rash. Also check to see if your nipples have changed position or look different than usual.

Next, perform a manual (with your hands) exam of your breasts. It is easiest and most effective to do this when you are either lying down or in the shower. With your three middle fingers, examine your breasts to feel for lumps or other changes. Use the pads of your fingers, instead of fingertips, and be sure to examine all of both breasts, as well as your underarms.

As you move your fingers to each area of your breasts, use different amounts of pressure so you can feel all of the breast tissue. Lighter pressure will help you feel breast tissue that is closer to surface of the skin, and stronger pressure will reach the tissue that is deeper within your breasts.

If you see or feel something different than what is normal for you, call your health care provider to schedule an examination.

Clinical Breast Exams

A clinical breast exam is done by a physician or health care provider. Many women have clinical breast exams as part of their annual well-woman visit with either their gynecologist or primary care provider.

Women should have a clinical breast exam at least once a year. You may choose to schedule your clinical breast exam and your annual mammogram six months apart. This will provide you two opportunities each year to be examined.

In addition to your annual clinical breast exam, you should see your health care provider any time you discover a change in your monthly breast self-exam.

What to Expect:

During a clinical breast exam, your health care provider will use their hands to feel the tissue in your breasts, underarms, and parts of your chest. They will examine you for lumps or any other abnormalities that may require additional testing.

When it comes to annual healthcare screenings, mammograms are among the most important for women—especially women who have a family history of breast cancer. American College of Radiology (ACR) recommends that all women at the age of 40 should begin receiving routine breast screening mammograms to monitor for disease. Additionally, Memorial Hermann encourages monthly breast self-examinations—which includes checking for lumps, dimpling of the skin, pain, nipple thickening or discharge, or any changes in breast shape or size—along with annual clinical breast exams from your primary healthcare provider.

No matter what age, women with higher-than-average risk for breast cancer—such as having a parent, sibling, or child with a Breast Cancer Gene (BRCA1 or BRCA 2 gene mutation)—should get a mammogram every year.

Note: All women are encouraged to discuss their individual risk factors with their healthcare provider.

All women should be familiar with the known benefits of mammograms, as well as how these exams are administered. The information below aims to answer all questions for first-time mammography patients at Memorial Hermann.

What is a mammogram?

A mammogram is a non-invasive X-ray image of the breast (mammary glands). A physician will use mammograms to detect and diagnose breast disease in women.

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What is a screening mammogram?

Screening mammograms are administered to women who have no signs or symptoms of breast cancer and are at average risk. A woman’s first screening mammogram is considered a baseline mammogram, as all future tests will be compared to this baseline to look for changes in breast tissue.

What is the recommended age to start breast screening?

Women of average risk for breast cancer should begin screening mammography at age 40 and continue screening annually. Those patients at increased risk for breast cancer may begin screening sooner. Women between the ages of 20 to 39 with average risk should receive a clinical breast exam once every one to three years. All women are encouraged to discuss their individual risk factors with their health care provider.

How do I know if I am at increased risk of developing breast cancer?

Women who may be at increased risk for developing cancer include those with history of radiation therapy to the chest, genetic mutation including an abnormality in the BRCA 1/BRCA or CHD1 genes, Bannayan-Rilet Syndrome, history of lobular carcinoma in situ, or a strong family history of breast cancer. Women and men with a strong family history should consider speaking to a genetic counselor.

What are the benefits of a regular mammogram?

Multiple prospective trials have shown significantly reduced mortality from breast cancer for women who undergo mammographic screening compared to those who do not.

What is the difference between a screening mammogram and a diagnostic mammogram?

According to the American Cancer Society, a screening mammogram is used when the patient does not have any concerning symptoms such as a lump in the breast, nipple discharge or breast skin changes. This exam usually consists of two standard images of each breast.

A diagnostic mammogram is performed for any concerning symptom. It consists of two standard images of each breast plus more focused images of the area(s) of concern. The additional pictures allow for more accurate and effective characterizations of the symptom.

Concerning symptoms include: a new lump in your breast, enlarged lymph nodes in the armpit, changes in the breast size, shape, skin texture, and/or color, skin redness, dimpling or puckering of the skin, scaliness of the breast, nipple pulling to one side, a change in direction of the nipple or new spontaneous bloody or clear nipple discharge from only one breast.

What is the difference between 2-D and 3-D mammography (tomosynthesis)?

A 2-D mammogram takes two-dimensional images of the breast: one from the top and the other from the side.

A 3-D mammogram acquires an extensive imaging data set that is reformatted into multiple thin slices of the breast tissue. This allows the radiologist to look through the layers of normal breast tissue and detect small findings that may not be visible on the conventional 2-D mammogram.

Because we are committed to providing early detection of breast cancer, Memorial Hermann uses only 3-D mammography at all locations where we offer mammograms. Tomosynthesis help us achieve the most accurate screenings and diagnoses.

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What is tomosynthesis and what are the benefits?

Tomosynthesis (3-D mammogram) is a new imaging technique that provides a three-dimensional image series for each breast. This allows the radiologist to see between the normal breast tissues and identify small areas of concern that are typically hidden in conventional 2-D images. The benefits are increased cancer detection rates by up to 30-40%, with 30-40% lower false-positive findings.

If I have small breasts can I get cancer?

Yes. All women are at risk for breast cancer regardless of breast size.

What does it mean if the skin on my breast is a different texture or color?

It might not mean anything, but it could be the sign of an infection or cancer. Any new skin changes of the breast should be evaluated by your health care provider.

If the skin is unusually warm and tender to the touch, red or a different color than normal, or you experience any swollen sensation with skin that resembles an orange peel, please speak to your health care provider immediately.

Can men get breast cancer?

Yes, men can get breast cancer, but their risks are much lower (approximately 100 times less). The American Cancer Society estimates that 2,600 new cases of invasive male breast cancer will be diagnosed this year, and approximately 440 men will die from breast cancer.

Should I get mammograms if I have implants?

Yes, mammograms can and should be performed on women with implants.

How much radiation exposure is there with a mammogram?

The amount of radiation exposure experienced during a mammogram is equivalent to a flight from Houston to Denver.

Do I need a physician’s order for a mammogram?

No order is necessary for a breast screening mammogram, however, a physician who is managing your care is required. Results of your mammogram will be sent back to that physician, and you will receive a summary letter of your exam from Memorial Hermann in the mail.

How do I schedule a mammogram?

Memorial Hermann has multiple locations throughout the Houston area that offer mammography.

To schedule your mammogram, click here or call 877.40.MAMMO.

If you have had other mammograms at a non-Memorial Hermann facility, please bring your scans to the appointment for the radiologist to review.