A mammogram is a low dose X-ray of the breast used to detect cancer and other changes before they can be seen or felt. Under the NHS Breast Screening Programme, women are invited from the age of 50, then every three years until their 71st birthday, and private mammograms are available from age 40, or younger where there is a clinical concern. At 108 Harley Street, mammograms are carried out using our Hologic Selenia Dimensions 3D system.
Types of mammograms
There are two main types of mammogram, and the difference comes down to how the image is captured. Both use low dose X-rays to look inside the breast, but they produce very different levels of detail. Your consultant will advise which is most appropriate for you, based on your age, your breast tissue and any symptoms or family history.
2D mammogram
A traditional 2D mammogram is a digital X-ray of the breast taken from two angles. The mammographer takes the first image from the top of the breast and the second from the side. This can be done for one breast (unilaterally) or both breasts (bilaterally), depending on what is being investigated.
The images allow our radiologists to detect breast cancer and other changes that are often too small to see or feel, which is why screening matters even when nothing seems wrong.
3D mammogram (tomosynthesis)
A 3D mammogram, also known as tomosynthesis, uses the same low dose X-ray approach but captures the breast as a series of thin image slices rather than a single flat picture. High powered computing then compiles those slices into a three dimensional view that radiologists can examine a millimetre at a time.
The benefit is clarity. Because the breast is viewed in layers, fine detail is far more visible and overlapping tissue is less likely to hide or mimic an abnormality. This can mean fewer call backs for additional images and greater confidence in the result, which is particularly valuable for women with dense breast tissue.
3D mammography (tomosynthesis) is widely available privately across the UK, and at 108 Harley Street it is carried out as part of our imaging service. If you would like to understand the cost of a private 3D mammogram, our team can talk you through current fees when you book.
3D mammograms are often recommended for:
- Younger patients and anyone with known dense breast tissue, where 2D images can be harder to interpret
- Patients with a new lump or another change that needs closer assessment
- Patients with a family history of breast cancer
- Patients with a current or previous breast cancer diagnosis who need detailed monitoring
What to expect from your tomosynthesis exam (PDF)
Contrast enhanced mammography
For some patients, we may recommend contrast enhanced mammography. It combines a standard low dose mammogram with an injected contrast dye that helps areas of concern show up more clearly, which can be helpful for assessing dense breast tissue or when a routine mammogram needs a closer look. Because iodine based contrast is used, our team carries out a safety check beforehand to confirm it is suitable for you.
You can read more about how it works and what to expect on our contrast enhanced mammography page.
What to expect during a mammogram
If you have never had a mammogram before, it is completely normal to feel a little anxious about what the appointment involves. The procedure itself is quick and straightforward, and knowing what happens beforehand tends to make it far less daunting. Here is what to expect from start to finish.
A mammogram is usually carried out by a mammographer, a radiographer who specialises in breast imaging. From arrival to leaving, the appointment typically takes around 30 minutes, though the imaging itself only lasts a few minutes.
- Your history is discussed. Before any images are taken, the mammographer will ask about your medical history, any breast symptoms, previous breast surgery and your family history. This helps them tailor the examination to you.
- You undress to the waist. You will be given privacy to remove clothing and jewellery from the upper body, and a gown to wear in between.
- Each breast is positioned in turn. The mammographer places one breast at a time on the machine’s flat plate, then lowers a second plate to hold it gently in place.
- The breast is briefly compressed. Compression flattens the tissue so the X-ray can capture a clear image with the lowest possible dose. It lasts only a few seconds per image and should not be painful, though some women find it briefly uncomfortable.
- The images are taken. Most screening appointments capture two views of each breast, one from the top and one from the side. You will be asked to stay still and hold your breath for a moment as each image is taken.
- Your results follow. A radiologist reviews your images and reports the findings. At 108 Harley Street, results are often available quickly, and your consultant will explain what they mean and whether any further investigation is needed.
A mammogram can show changes in the breast that are too small to see or feel, including areas of calcification, cysts, and masses that may need a closer look. It is important to remember that most changes picked up are not cancer, and many turn out to be benign. Where an image does raise a question, it simply means your consultant will recommend a further test, such as an ultrasound or biopsy, to understand it fully.
How often should you have a mammogram?
How often you need a mammogram depends mainly on your age and your personal risk, and it is one of the most common questions women have when they start thinking about breast screening. The short answer is that routine NHS screening follows a set schedule, while private screening gives you more flexibility over timing.
Under the NHS Breast Screening Programme, women are invited for screening from the age of 50, with the first invitation arriving between the ages of 50 and 53, and then every three years until their 71st birthday. After 71 you are no longer automatically invited, but you can still request a screen every three years. The programme works on a three year cycle because most breast cancers develop in women over 50, and screening at this interval is where the evidence shows the clearest benefit.
There are two situations where this standard schedule may not be enough on its own:
- If you are under 40, a mammogram is not usually the first choice, because younger women tend to have denser breast tissue that makes the images harder to interpret. An ultrasound is often more appropriate, and your consultant can advise on the right approach.
- If you have a higher risk of breast cancer, for example a strong family history, you may be eligible for screening before the age of 50. Risk is assessed individually, so it is worth discussing your history with a specialist rather than waiting for a routine invitation.
Many women also choose private screening simply because they would rather not wait for their NHS invitation, want screening between their three yearly appointments, or have a concern they want looked at promptly. At 108 Harley Street, you can arrange a private mammogram from the age of 40, or younger where there is a clinical reason to, without waiting for an NHS letter.
Whatever your age, screening does not replace being aware of your own breasts. If you notice any unusual change between appointments, such as a lump, a change in shape or skin, or nipple changes, contact a specialist promptly rather than waiting for your next routine screen.
How to book a mammogram: self-referral explained
One of the advantages of private breast screening is that you do not always need a GP referral to be seen. If you have no breast symptoms, you can usually self-refer for a mammogram, which means booking directly without waiting for a letter or a doctor’s note.
To self-refer for a routine screening mammogram, you should:
- Have no current breast symptoms. Self-referral is for routine screening. If you have noticed a lump, pain, nipple changes or any other symptom, you should still book in, but you will be seen through a symptomatic assessment rather than routine screening, so your consultant can investigate properly.
- Be registered with a GP. This allows your results and any onward care to be shared appropriately with the rest of your healthcare team.
- Be aged 40 or over, or younger where there is a clinical reason. Below 40, an ultrasound is often the more suitable first option.
If you do have symptoms, there is no need to arrange a referral first. You can book a consultation directly, and our breast team will carry out the appropriate assessment, which may combine an examination, a mammogram and an ultrasound depending on what is needed.
At 108 Harley Street, appointments are often available quickly, and our team can talk you through what your appointment will involve and any fees before you attend. To arrange your mammogram, you can book an appointment online or contact our team directly.