You are ignorant and are of harm to women.  I have an annual breast exam and mammogram since 1988. I have a breast exam by my own doctor who also ask me questions of any problems I may be having along with my past history  ( cyst removed on right breast inn 1991) gives me a prescription for a mammogram at any facility that can provide that service. The doctors evaluation is a first step in the process and is required by all insurances to have the procedure done. My doctor receives the results of my mammogram after it is reviewed by a Doctor of Radiology and my doctor notifies me of my results.   Planned Parenthood operates with this standard procedure, there is a doctor's visit, an exam and patient history and evaluation and a prescription is given to he patient by the doctor and the patient makes the appointment where the procedure of a mammogram is offered and the results are sent back to the doctor who ordered the mammogram who then contacts their patient.