If you have a pacemaker, it’s normal to have questions about what you can and can’t do, especially when it comes to medical tests. Many people with pacemakers worry about whether it is safe to get a mammogram when they have a device in their chest.
Here’s the good news: It’s safe to get a mammogram if you have a pacemaker. Mammograms are a very effective and important tool to find breast cancer early.
To clear up any confusion, we talked with Brian Johnston, MD, a diagnostic radiologist at Banner MD Anderson Cancer Center. His advice can help you understand the process, prepare for your appointment and feel more confident about your screening.
Is it safe to get a mammogram with a pacemaker?
Yes. Most women with a heart device like an implantable cardioverter-defibrillator (ICD), pacemaker or rhythm monitor can still get breast cancer screenings.
“If proper precautions are taken by the technologist performing the exam, the mammogram will not harm the device,” Dr. Johnston said. “The X-ray beams from the mammogram will also not harm the implanted device.”
The mammogram machine compresses the breast tissue so the radiologist can see it more clearly. Although this pressure might feel a little uncomfortable, if proper care is taken when compressing the breast, it won’t harm your pacemaker or its wires (leads).
But there is one exception.
“Patients with devices that have been very recently implanted in the chest wall may need to wait a few weeks or months for the surrounding tissue to heal before getting a mammogram,” Dr. Johnston said.
He suggests asking your health care provider who put the device in how long you should wait before your first breast screening.
Can a pacemaker affect mammogram images?
A pacemaker might cover up small areas of the breast on a mammogram. But that doesn’t mean the exam won’t work.
“A pacemaker can obscure small portions of breast tissue and armpit (axillary) tissue, which could potentially limit the detection of an abnormality underlying the device,” Dr. Johnston said. “But this should not stop a patient from getting a mammogram.”
Why not? Because mammography technologists know exactly how to handle implanted devices.
“Mammography technologists are experts in positioning the breast in the machine to get the best possible images of the tissue associated with and around the device,” Dr. Johnston said.
They might take an extra picture in the area of the pacemaker to make sure nothing is missed. This is nothing to worry about.
What to tell your technologist before your mammogram
The best thing you can do to prepare for your screening is to tell your technologist if you have a pacemaker.
“Tell the technologist you have an implanted device in your chest wall and where it is located,” Dr. Johnston said. “They can help protect the device while the surrounding tissue is compressed.”
Your technologist might feel your device or look at your scar to see where it is. This helps them choose the right angle, adjust pressure or take extra pictures if needed.
Your comfort and safety are always the priority.
What adjustments can be made during the mammogram?
Since everyone's body is different, each pacemaker fits a little differently. That’s why your technologist might make a few simple changes. They may use:
- Gentle compression: The technologist will apply lighter pressure over the area where your pacemaker sits.
- Different arm positions: Raising or lowering your arm can shift breast tissue away from the device.
- Extra angled view: If the pacemaker blocks part of the image, additional pictures help fill in the missing areas.
- Modified positioning: The technologist may slightly rotate your body to better capture tissue around the device.
These small changes can help your radiologist get the most complete view of your breasts.
Are there alternatives to a mammogram?
A mammogram is still the most trusted way to check for breast cancer. But sometimes, you might need extra scans.
“If an implanted device significantly obscures surrounding breast tissue, an ultrasound can be performed to supplement a mammogram,” Dr. Johnston said. “The radiologist interpreting the mammogram may recommend additional ultrasound in those instances.”
Ultrasound does not hurt and helps see areas that may be harder to see on a mammogram.
How to prepare for your mammogram when you have a pacemaker
You don’t need a special routine but a few steps can make your appointment smoother.
- Tell the imaging center about your device when you schedule: Tell them about your pacemaker so they can give you extra time. Your technologist is well-trained in dealing with implanted devices.
- Ask how long you should wait after getting a device: It’s best to wait a little while after placing the device so the tissue around it can heal. Ask your care team who placed the device about how long to wait before your next mammogram.
- Wear a two-piece outfit: You’ll only need to remove your top.
- Avoid deodorant, lotion or powders: These can appear as spots in the images.
- Bring your device card: This helps your technologist understand your specific model and placement.
- Speak up if anything feels uncomfortable: A mammogram with a pacemaker is similar to a regular exam. You might feel some light pressure near the device or a pulling sensation. You should not feel sharp pain or direct pressure on the device itself.
Let the technologist know if you feel pain or discomfort. They can always stop, reposition you and try again.
Learn more about what to expect during a mammogram.
When to call your provider after the screening
It is rare to have problems after a mammogram. But call your provider if you notice:
- Swelling around your pacemaker
- Pain that gets worse
- A feeling that the device has shifted
- Changes in your heartbeat
Takeaway
Having a pacemaker doesn’t mean you can’t have breast cancer checks. Mammograms are safe, important and effective, even if you have a pacemaker. With some small changes and a technologist who is aware of your device, you can get the care you need safely.
You deserve to take care of your heart and breast health. Talk to your health care provider or a Banner Health specialist to answer any questions.
