You can go many places to get a mammogram-breast
clinics, radiology departments of hospitals, mobile vans, private
radiology practices, doctors' offices. Your doctor can arrange for
a mammogram for you, or you can schedule the appointment yourself.
It is important to choose a facility carefully, however, because
quality can vary widely from one place to another. One good way to
tell if a facility measures up is to find out if it is accredited
by the American College of Radiology (ACR).
Facilities accredited by the ACR have their equipment,
personnel, and procedures evaluated and approved. To be accredited,
facilities must have doctors and other staff members who have been
specially trained to perform and interpret breast x-rays. They also
must have equipment capable of producing high-quality mammograms
with the lowest possible amount of radiation exposure. And they
must perform mammography regularly and frequently.
To find out if a facility is ACR-accredited, you can ask to see
its ACR certificate, or you can call the Cancer Information Service
at 1-800-4-CANCER (1-800-422-6237).
The ACR program is voluntary, and not all high-quality
facilities have yet been accredited. If you are considering a
facility that is not ACR-accredited, you will want to be sure that
your mammogram will be taken with the proper equipment and that the
people who take the x-rays and those who check them are properly
The following questions will help you in making your selection.
Don't hesitate to call and ask these questions before you make an
appointment. A qualified facility should have staff able to answer
your questions easily. Choose one whose staff answer "yes" to all
Q. Does the facility use machines specifically
designed for mammography?
These are called "dedicated" mammography machines. You
should not choose a facility that x-rays the breast with a machine
used to take x-rays of the bones and other parts of the body.
Q. Is the person who takes the mammograms a
Mammographic technologists are trained to position the
breast correctly to get a good image. They should be certified by
the American Registry of Radiological Technologists or be licensed
by the state.
Q. Is the radiologist who reads the mammograms
specifically trained to do so?
The mammograms should be read by a board-certified
radiologist who has taken special courses in mammography.
Q. Are mammograms a regular part of the facility's
Studies have shown that facilities performing large
numbers of mammograms are likely to comply with many quality
standards. The ACR suggests choosing a facility that performs at
least 10 mammograms each week.
Q. Is the mammography machine calibrated at least
once a year?
The machine should be checked by a radiological
physicist and adjusted as necessary to be sure that its
measurements and doses are correct.
In addition to quality, another important consideration is cost.
Most mammograms cost between $50 and $150. More than 40 states now
have laws requiring health insurance companies to reimburse all or
part of the cost of screening mammograms; check with your insurance
company. For women 65 and older, the federal Medicare program pays
some of the cost for screening mammography once every 2 years.
Some health service agencies and some employers provide
mammograms free, or at low cost. Low cost does not mean low
quality, however. A large government survey found that some of the
facilities charging the lowest fees (often because they deal in
large volumes) were among the best in terms of complying with
Your doctor, local health department, clinic, or chapter of the
American Cancer Society, as well as the Cancer Information Service,
may be able to direct you to low-cost programs in your area.