Breast Care A-Z · Imaging · MAMMO

Mammogram

also: mammography, breast X-ray, screening mammogram, diagnostic mammogram

A mammogram is a low-dose X-ray of the breast used both to screen for cancer before symptoms appear and to investigate a breast change. You may have been invited for screening, referred because of a symptom, or be weighing up a private mammogram; this page explains what to expect and what the results can and cannot tell you.

Quick answers

How much does a private mammogram cost in the UK?

Private mammogram fees vary by clinic and by whether the mammogram is done on its own or as part of a one-stop breast assessment with ultrasound and clinical examination. Current Breastory fees are available from the PA — see the [fees and insurance page](/fees-insurance/) and [Dr Tsang-Wright's PHIN profile](https://www.phin.org.uk/search/consultants) for published fee information.

Does a mammogram hurt?

Most people describe a mammogram as uncomfortable rather than painful. The compression lasts only a few seconds per view. If your breasts are tender around your menstrual cycle, the week after a period is usually more comfortable.

At what age should I start having mammograms?

In the UK, the NHS Breast Screening Programme invites women aged 50 to 70 every three years. Women with a significant family history of breast cancer, or with certain genetic risk factors, may be offered earlier screening under a separate high-risk programme. Outside the NHS, private mammography is available from around age 40, and sometimes younger if there is a specific reason.

BREASTORY ENCYCLOPEDIA · PLATE XXXV RADIOLOGY · DIAGNOSTIC IMAGING mammogram film-screen & digital mammography radiographic imaging of breast tissue for the detection of cancer and pre-malignant change i FIG 01 Mammogram Views — Standard Positioning X-RAY compression paddle breast parenchyma detector plate Craniocaudal (CC) top-down view · beam vertical ii iii v X-RAY pect. breast Mediolateral Oblique (MLO) 45° angle · includes pectoral muscle i iv iii i = X-ray source ii = compression paddle iii = breast parenchyma iv = pectoral muscle (MLO) v = detector plate STANDARD PROTOCOL 2 views per breast (CC + MLO) Compression force ~10 kg applied Radiation dose ~0.4 mSv per exam Results within 7–10 working days NHS screening age 50–70 · 3-yearly UK M-CATEGORY · BI-RADS (international) M1–M2 (BI-RADS 1–2) Normal/benign Routine recall M3 (BI-RADS 3) Probably benign 6-month follow-up M4–M5 (BI-RADS 4–5) Suspicious Biopsy required Double-read by two radiologists independently (UK NHS standard) Result letter posted within 2 weeks i FIG 02 Normal vs Abnormal Mammogram Findings Normal mammogram Abnormal findings Tissue density Fatty / scattered / heterogeneous / dense High density obscures lesions Mass present None Irregular or spiculated mass Calcifications Fine scattered benign forms Pleomorphic / linear cluster Asymmetry Symmetric glandular tissue New or focal asymmetry Architecture Preserved / regular trabecular Distortion or retraction Skin Regular, uniform thickness Thickening or dimpling Lymph nodes Oval shape with fatty hilum Dense, enlarged axillary nodes Nipple Regular position and appearance Inverted or new retraction Ducts Not visible / normal Retroareolar mass or duct ectasia Overall impression BI-RADS 1 or 2 BI-RADS 3, 4, or 5 i FIG 03 BI-RADS Classification System BI-RADS Category Description Action 1 — Negative No finding identified Routine screening 2 — Benign Definite benign finding Routine screening 3 — Probably benign Short-interval follow-up 6-month mammogram 4A — Low suspicion Biopsy advised Core biopsy 4B — Moderate suspicion Biopsy required Core biopsy 4C — High suspicion Probably malignant Biopsy + MDT review 5 — Highly malignant Classic malignancy features Biopsy + staging 6 — Known malignancy Biopsy-proven cancer Treatment planning 0 — Incomplete Needs additional imaging Further views / USS i FIG 04 Mammogram Clinical Pathway GP / Screening referral Appointment booking mobile unit Image acquisition 2 views Double-read reporting radiologist Results letter 7–10 days Recall / discharge outcome Recall rate ~5% · Assessment clinic within 3 weeks · 95% discharged after further assessment Symptomatic referral via 2-week wait pathway — GP to breast clinic directly Digital breast tomosynthesis (DBT) increasingly used; may reduce recall rates by 15–20% Contrast-enhanced mammography (CEM) an emerging modality for dense breasts AI-assisted reading now validated as single reader in NHS trials (PRIMORDIAL, EDITH) i FIG 05 Key Radiological Findings Spiculated mass Irregular, star-shaped density with radiating spicules. High suspicion for invasive carcinoma. BI-RADS 4–5. SUSPICIOUS Microcalcifications Tiny calcium deposits (<0.5 mm). Linear/branching = high suspicion for DCIS or invasive disease. ASSESS MORPHOLOGY Architectural distortion Normal tissue pulled toward focus without visible mass. May indicate radial scar or invasive cancer. BIOPSY REQUIRED Asymmetric density Unilateral glandular asymmetry versus contralateral breast. New asymmetry warrants recall. COMPARE WITH PRIOR Skin thickening Diffuse or focal skin thickening >2 mm. May indicate inflammatory carcinoma or lymphatic oedema. CLINICAL CORRELATE Axillary adenopathy Enlarged, dense axillary lymph nodes without fatty hilum. May indicate nodal metastases. STAGING REQUIRED i FIG 06 Key Statistics ~84% sensitivity for screen-detected cancer [1] Houssami 2014 ~91% specificity for standard mammography [2] Lehman 2005 ~5% recall rate for further assessment [3] NHS BSP 2023 7–10 working days for routine result [4] ACR BI-RADS i FIG 07 References 1. Houssami N et al. Mammography sensitivity. Breast. 2014. 2. Lehman CD et al. Diagnostic accuracy of digital versus film mammography. NEJM. 2005;353:1758–1766. 3. NHS Breast Screening Programme. Technical standards for breast screening radiology. 2023. 4. ACR BI-RADS Atlas, 5th edition. American College of Radiology. 2013. 5. PHE. Breast screening quality assurance framework. Public Health England. 2022. 6. Pisano ED et al. Digital mammographic imaging screening trial (DMIST). NEJM. 2005;353:1773–1783. 7. Marmot MG et al. The benefits and harms of breast cancer screening. Lancet. 2012;380:1778–1786. All content for educational purposes only. Consult a qualified radiologist for clinical interpretation. Content reviewed against ACR BI-RADS 5th Ed., NHS BSP technical standards, and RCR guidelines. Clinically authored by Dr Fiona Tsang-Wright , FRCS (Gen Surg) GMC 4549831 · ORCID 0000-0003-4801-026X
Visual Reference · Mammogram
Open full size ↗
Definition
A mammogram is a low-dose X-ray of the breast, used both to screen for breast cancer in women who have no symptoms and to investigate a lump, pain, or other breast change.
≈ 20% Breast-cancer-mortality reduction in women invited to UK screening 2

Common questions The questions patients ask first

How much does a private mammogram cost in the UK?
Private mammogram fees vary by clinic and by whether the mammogram is done on its own or as part of a one-stop breast assessment with ultrasound and clinical examination. Current Breastory fees are available from the PA — see the [fees and insurance page](/fees-insurance/) and [Dr Tsang-Wright's PHIN profile](https://www.phin.org.uk/profiles/consultants/fiona-tsang-wright-159844?) for published fee information.
Does a mammogram hurt?
Most people describe a mammogram as uncomfortable rather than painful. The compression lasts only a few seconds per view. If your breasts are tender around your menstrual cycle, the week after a period is usually more comfortable.
At what age should I start having mammograms?
In the UK, the NHS Breast Screening Programme invites women aged 50 to 70 every three years1. Women with a significant family history of breast cancer, or with certain genetic risk factors, may be offered earlier screening under a separate high-risk programme. Outside the NHS, private mammography is available from around age 40, and sometimes younger if there is a specific reason.
I have dense breasts — is a mammogram still worthwhile?
Yes — mammography still picks up many cancers in dense breasts, particularly through microcalcifications2. But because dense tissue can mask some cancers on mammography, additional imaging with ultrasound, and sometimes MRI, is often used alongside the mammogram for people with dense breasts45.

A mammogram is a low-dose X-ray of the breast, used both to screen for breast cancer in women who have no symptoms and to investigate a lump, pain, or other breast change.

Mammograms are the most widely used imaging test for breast cancer. There are two broad purposes: screening mammograms are offered at regular intervals to people without symptoms to pick up cancers early, and diagnostic mammograms are done when there is a specific concern, such as a lump, and are usually combined with ultrasound and sometimes a biopsy in the same visit.

Orientation Why you might be reading about this

You have been invited for a screening mammogram, referred for a diagnostic mammogram because of a breast change, or are weighing up whether to arrange a private mammogram. This page explains what a mammogram is, what to expect on the day, and what the results can and cannot tell you.

Related terms: Breast ultrasound · Breast MRI · Tomosynthesis · Triple assessment · Microcalcification · Breast density

The procedure How a mammogram is done

A mammogram is taken by a specially trained radiographer using a dedicated mammography machine. The breast is placed onto a flat plate and a second plate is lowered to compress it gently. Two views are taken of each breast — one from above and one from the side. Compression spreads the breast tissue so that small abnormalities are easier to see and reduces the X-ray dose needed. Each compression lasts only a few seconds; most people describe it as uncomfortable but brief. The whole appointment usually takes less than 20 minutes.

Two purposes Screening versus diagnostic mammograms

A screening mammogram is offered at regular intervals to people without breast symptoms, to pick up early breast cancer before it is felt as a lump. In the UK, the NHS Breast Screening Programme invites women aged 50 to 71 every three years, with the first invitation between ages 50 and 531, with older women able to self-refer. The programme is supported by independent UK review evidence of meaningful breast cancer mortality reduction3.

A diagnostic mammogram is performed when there is a specific concern — a lump, pain, a change in the breast or nipple, or follow-up after a previous finding. Diagnostic mammograms are usually combined with ultrasound and, where indicated, a biopsy as part of a triple assessment in a one-stop breast clinic. For symptomatic women, mammography is the first-line investigation from age 40 (ultrasound is preferred under 40), per Royal College of Radiologists guidance.

3D mammography Tomosynthesis (3D mammography)

Most modern mammography machines can also take tomosynthesis images — a series of thin-slice views that the radiologist reads as a 3D reconstruction of the breast. Tomosynthesis improves the detection of some cancers, particularly in women with dense breast tissue, and reduces the rate of unnecessary recalls4.

Limitations What a mammogram can and cannot show

A mammogram is very good at picking up microcalcifications (the tiny specks of calcium often associated with DCIS) and at showing masses with typical cancerous features. It is less reliable in women with dense breast tissue, where cancers can be harder to distinguish from the surrounding tissue2. For this reason, mammography is often combined with ultrasound — and in selected patients with MRI — rather than relied on alone5.

A normal mammogram is reassuring but not an absolute guarantee. Any breast change that persists — a lump, skin change, nipple change — should still be examined, even if a recent mammogram was normal.

What to expect What to expect at your appointment

  • Bring any previous mammograms or imaging if you have them — comparison with prior imaging significantly improves interpretation.
  • You will be asked to undress to the waist, so a two-piece outfit is easier.
  • Deodorant, body lotion, or talc on the chest area can show up on the X-ray as small white dots and lead to a recall, so avoid them on the day.
  • Results from a screening mammogram are usually posted within two weeks1. Results from a diagnostic mammogram done as part of a one-stop assessment are usually discussed on the same day.

Read more on the imaging services page and the one-stop clinic page.


Resources Further reading

Sources & guidance

Every figure on this page is anchored to a published source. Tap a number in the text or below to jump to the reference.

  1. guidance Public Health England / NHS Breast Screening Programme. NHS Breast Screening Programme: how it works. London: gov.uk. 2024 https://www.gov.uk/guidance/breast-screening-programme-overview Cited for: NHS breast screening invitation: women aged 50–70 every three years; double-reading; results posted within two weeks.
  2. cohort Pisano ED, Hendrick RE, Yaffe MJ, et al. Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST. Radiology. 2008 ;246(2):376–383 doi:10.1148/radiol.2461070200 Cited for: Digital mammography is at least equivalent to film and superior in dense breasts and younger women.
  3. meta analysis Marmot MG, Altman DG, Cameron DA, Dewar JA, Thompson SG, Wilcox M (Independent UK Panel on Breast Cancer Screening). The benefits and harms of breast cancer screening: an independent review. British Journal of Cancer. 2013 ;108(11):2205–2240 doi:10.1038/bjc.2013.177 Cited for: UK independent review of breast screening — mortality reduction (~20%) and overdiagnosis estimate; underpins UK programme design.
  4. cohort Houssami N, Bernardi D, Pellegrini M, et al. Breast cancer detection using single-reading of breast tomosynthesis (3D-mammography) compared to double-reading of 2D-mammography: evidence from a population-based trial (STORM-2). European Journal of Cancer. 2017 ;76:111–117 doi:10.1016/j.ejca.2017.02.010 Cited for: Tomosynthesis (3D mammography) increases cancer detection and reduces recall rate compared with conventional 2D mammography, particularly in dense breasts.
  5. guidance Royal College of Radiologists. Guidance on screening and symptomatic breast imaging. 4th edition. London: RCR. 2019 https://www.rcr.ac.uk Cited for: UK practice for symptomatic breast imaging — combination of mammography, ultrasound, and selective MRI in triple assessment.