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The breasts can undergo changes that cause symptoms such as lumps or pain. Benign breast conditions are common, and non-cancerous. However, early detection of breast cancer is critical. A mammogram is a very safe X-ray exam that uses low doses of radiation to detect changes in the breast that may be too small or subtle to be felt during breast self-exams.

Screening Mammography

Screening mammography is used to find early-stage cancer before it grows large enough that you can feel it and before it has a chance to spread outside of the breast. Early-stage breast cancer is usually curable and is more easily treated with less invasive and less toxic therapy than is late-stage cancer. Approximately less than 10% of routine mammograms are interpreted as possibly abnormal and require additional breast imaging with mammography and/or breast ultrasound. Out of 1,000 women who have a routine mammogram: the number called back for additional imaging is less than 100 and the number needing a minimally invasive biopsy is 10 and ultimately 2 cancers will be found in that group of 1,000 women. It is very important to undergo the additional imaging to know which of the abnormal routine exams are truly worrisome. These are separate exams and are billed separately in addition to the routine mammogram.

Your primary care provider may help decide if supplemental imaging is recommended for you based on your personal and family history. However, you are welcome to ask the mammography technologist and radiologist if you have questions about the most appropriate exam for you. How often you have a mammogram may depend on your age, family history, risk for breast cancer and overall health. Screening mammography does not require a physician referral and is covered by most insurance companies.

When Should I Start Having Mammograms?

Women who prefer to maximize life-extending benefits and seek improved treatment options for breast cancer should choose annual screening starting at age 40. They should continue as long as they are in good health.

Get the facts about your options for starting mammograms, with this decision aid on our Dartmouth-Hitchcock Healthwise® Health Encyclopedia website.


Dartmouth-Hitchcock offers the latest breast health services and mammography breast exams including 2-dimensional (2-D) digital mammography and 3-dimensional (3-D) digital breast mammography tomosynthesis.

2-D mammography

In 2-D digital mammography, a low dose X-ray beam shines through the breast and creates a digital image receptor, similar to the working of a digital camera. This ‘image’ is viewed on a computer monitor by a mammography technologist in a matter of seconds. The images are then sent electronically for the radiologist to interpret. 2-D digital mammography is the standard breast exam for most women.

3-D mammography

3-D digital mammography (also known as breast tomosynthesis), is a breast imaging exam that improves the accuracy of mammography. In women having screening, 3-D digital mammography may be done along with a traditional 2-D digital mammography exam. Sometimes, 3-D mammography may be used to evaluate an abnormality like a breast lump. The 3-D mammogram is very similar to a 2-D mammogram. However, with 3-D mammography the X-ray tube moves and a series of mini X-ray exposures are obtained, creating a digital data set, which is then reconstructed into 1 millimeter thick slices or layers. The radiologist views each individual layer of the breast rather than a shadow of the entire breast. As a result, radiologists can detect breast cancer that was hidden by overlying tissue and that may mimic cancer and lead to a false alarm or unnecessary callback. 3-D mammography is offered at our Concord, Lebanon, Manchester and Nashua locations.


Mammography is available at the following Dartmouth-Hitchcock locations:

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