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First Mammogram? Here Are 10 Facts to Ease Your Fears

Anxiety is a common reason (and strong motivator) for people to hold off from doing something, but don’t let it stop you from getting your first mammogram.

You might have heard it is painful. You might think you’re in good health and don’t need one. Or you might know someone who has breast cancer, and you fear your potential results.

‘Scanxiety’ is normal, especially when you don’t know what to expect. But a screening mammogram doesn’t need to be a scary experience. If you know what to expect, you’ll find it less intimidating—and surprisingly not so bad.

The importance of screening mammograms

The truth is that screening mammograms have reduced breast cancer deaths by 40% since 1990 - thanks to early detection when cancer is more treatable, and remain the only screening test proven to reduce breast cancer deaths.

“This life-saving benefit is maximized when women start undergoing yearly screening mammograms at age 40 and continuing for as long as they are in good health,” said Vilert Loving, MD, chief of breast imaging at Banner MD Anderson Cancer Center in Arizona.

Debunking mammogram myths

To help put your mind at ease, Dr. Loving dispelled some common mammogram myths and provided helpful tips to ensure your first scan goes smoothly.

Myth #1: Mammograms are painful.

Fact: Everyone has a different pain threshold, but the compression or squeezing involved with a mammogram is often described as uncomfortable but not painful. In most cases, the pressure or squeeze you feel only lasts a few seconds.

“Most women rate the pain associated with mammograms to be minimal to moderate,” Dr. Loving said. “One study found that 94% of women would have a mammogram again, despite mammogram-associated pain. This conclusion suggests that the pain is not significant enough to deter women from the life-saving benefit of this test.”

Feel free to take aspirin, acetaminophen or ibuprofen about an hour before your mammogram if you’re worried about pain or have experienced discomfort during past mammograms. In addition, consider scheduling your mammogram for the week after your period, or menstrual cycle, when your breasts tend to be less tender.

Myth #2: Mammograms require a doctor’s order.

Fact: You don’t need a referral from your health care provider to schedule a mammogram. If you are a woman 40 years of age or older, you should have a mammogram once a year, even if your provider forgets to mention it.

Ready to schedule your mammogram? To schedule a mammogram, find a breast imaging center near you or contact the National Cancer Institute (1-800-4-CANCER) or the American College of Radiology (1-800-227-5463) to find a certified mammography provider.

Myth #3: If I don’t have a family history of breast cancer, I don’t need a mammogram.

Fact: Annual mammogram screenings starting at age 40 are always recommended. Why? The majority of women who are currently diagnosed with breast cancer had no family history.

Between 75% to 80% of all newly diagnosed breast cancers in the U.S. are in women with no family history of breast cancer,” Dr. Loving said. “Therefore, women without a family history of breast cancer should not skip or delay screening mammograms.”

Breast cancer screening guidelines differ for women at higher-than-average breast cancer risk. “Women who may be at elevated breast cancer risk due to family history or other risk factors should discuss options with their health care provider, as they may benefit from a more intensive screening schedule or risk-reducing treatments,” Dr. Loving said.

[Also read “Am I At Risk of Breast Cancer.”]

Myth #4: A normal mammogram means I can skip next year’s mammogram.

Fact: Early detection is key. “The goal of a screening mammogram is to find breast cancers early when they are more easily treatable, increasing the chances that the cancer can be completely cured when diagnosed,” Dr. Loving said.

Since some breast cancers are aggressive and grow quickly, it’s important to have your screening mammogram every year so that any cancer can be found at its earliest stages. Most often early-stage cancers are too small to be felt by hand, so you could very well feel normal during a self-breast exam.

“If we were to delay screening and wait for women to ‘know’ they have cancer (for example, by feeling a breast lump), many of these cancers would then be more advanced and more difficult to cure,” Dr. Loving said. “Again, it’s important you don’t delay your regular screening mammogram.”

Myth #5: The radiation from a mammogram causes cancer.

Truth: Mammograms use low-dose X-rays, which are set at the lowest radiation amount needed to produce accurate images of your breast tissue without it being harmful. The amount of radiation from a mammogram is the same as you would get from your day-to-day life over the course of about two months.

“We are exposed to radiation every day on the Earth from sources such as rocks, sunlight and even naturally in some foods,” Dr. Loving said. “At low levels, this natural background radiation is not high enough to cause harm. The amount of radiation from a mammogram is equal to about 7 weeks of this natural background radiation. The health risk from this level of radiation is extremely low, and the life-saving benefits far outweigh this low radiation risk.”

A mammogram machine has two flat paddles that are used to compress your breasts. The reason for the compression is to spread the tissue apart and hold the tissue still for pictures. That allows a lower dose of radiation to be used and better images for your radiologist, the doctor who reviews your images.

Myth #6: I’m too young to have to worry about my breast health.

Fact: Breast awareness can start at any age, meaning you can become aware of how your breasts normally feel. This awareness will help you distinguish abnormal breast lumps from normal breast tissue.

At age 30, discuss with your health care provider if you are at an elevated risk for breast cancer and may ultimately benefit from a more intensive breast screening plan and/or cancer risk-reducing treatments. As mentioned earlier, for those with average risk, annual mammogram screenings should start at age 40.

Myth #7: Traditional mammograms and 3D mammograms are the same.

Fact: Tomosynthesis, also called 3D mammogram, has been shown to significantly increase breast cancer detection over conventional or 2D mammograms. A 3D mammogram can produce clear and detailed images of the entire breast from different angles, thereby producing 3D imaging for your radiologist to review. A 2D mammogram only produces images from one single angle at a time.

Because of its higher level of detail, 3D imaging improves the ability to accurately detect early-stage breast cancers and decreases the chance for false alarms.

Myth #8: Mammograms are expensive.

Fact: Due to the Affordable Care Act of 2010, screening mammograms are covered 100% by virtually all insurance plans with no cost to you. There may be a cost for the 3D portion of a 3D mammogram, though this varies by insurance company.

You may also be eligible for free or low-cost screenings. The Centers for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program provides breast and cervical screenings and diagnostic services to those who have low incomes and are uninsured or underinsured.

Myth #9: I can’t get screened because I have dense breast tissue or breast implants.

Fact: Breast cancer screenings are safe for everyone – whether you have dense breast tissue or breast implants. “In fact, breast density increases a woman’s risk of breast cancer so they should absolutely have yearly mammograms,” Dr. Loving said.

If you have breast implants, let the mammography center know when you schedule your appointment. You may be positioned differently and have additional images taken, but a mammogram shouldn’t rupture an implant.

“We have special views where we can comfortably push the implant out of the way to allow imaging of the breast tissue,” Dr. Loving said.

Myth #10: The COVID-19 vaccine will affect my mammogram results—or worse, give me cancer.

Fact: “There’s no evidence that COVID-19 vaccines cause cancer,” Dr. Loving said. “The vaccine does trigger inflammation, but this inflammatory response is expected as your body is producing antibodies to protect itself from the coronavirus.”

In some cases, however, your inflammatory immune response may be strong enough to enlarge the lymph nodes under the arm in which you received your vaccine. These enlarged underarm lymph nodes may be seen on your mammogram. Therefore, if you’ve received the COVID-19 vaccine recently, please let the imaging center staff know the date(s) of your vaccine and in which arm/leg your injections were received.

Tips before you go—even if it’s not your first mammogram

  • The day of your mammogram, avoid deodorant, creams, lotions or perfumes on your chest, breasts or underarm areas (armpits) since these skin products may make your mammogram more difficult to review. But feel free to toss them in a purse to bring with you to the appointment for afterward.
  • It’s not necessary to fast before having a mammogram, so feel free to eat and drink as usual.
  • Consider wearing a two-piece outfit, so you only need to remove your top for the mammogram.
  • If you’re still having a monthly menstrual cycle, try scheduling your mammogram for the week after your period.
  • If you’re receiving a mammogram outside of your regular imaging center, please bring all your prior images to your appointment or bring the name, address and phone number for the facility where you had your prior mammogram exams.

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Women's Health Breast Cancer Imaging

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