What Can You Expect During Your First Mammogram? And Other Questions, Answered

What Can You Expect During Your First Mammogram? And Other Questions, Answered
Photo: Chompoo Suriyo, Shutterstock

It’s still Breast Cancer Awareness Month for another day, but mammograms are important year-round. And while some may have had their fair share of appointments over the years, others are just entering — or approaching — that point in their lives. But even with previous experience, mammograms can be sources of stress and anxiety.

To make things a little easier — and ideally, more bearable — for everyone involved, we’ve put together this guide to help walk you through the process, with input from experts as well as others who have been on the opposite side of the machine. Given how much information is out there on mammography and breast cancer, we can’t address everything here, but we hope that this information will at least help you prepare for your next (or first) appointment.

What is a mammogram?

A mammogram is an X-ray picture of the breast used to detect early signs of breast cancer — sometimes even before you’d be able to feel any lumps during self-exams. Currently there are the traditional 2-D mammograms, as well as a newer type called digital breast tomosynthesis (or 3-D mammogram), which aren’t available at all breast imaging centres yet but are becoming increasingly common.

If you’re unsure at what age or frequency you should be getting mammograms, check the guidelines established by the American Cancer Society. If you have a family history of breast cancer, you may start getting yours in your 30s instead of your 40s. Your first mammogram is also referred to as your “baseline mammogram” because it serves as a point of comparison for all your future mammograms.

And even though mammograms do use a small amount of radiation, that doesn’t mean they’re unsafe. For example, the radiation dose from a mammogram is equal to around two months of the usual background radiation for the average person. “One common myth is that mammograms cause cancer,” Dr. Priyanka Vaidya, a general practitioner at Pall Mall Medical tells Lifehacker. “This is [inaccurate], as mammograms utilise very small doses of radiation — it’s like getting an X-ray, therefore meaning it doesn’t cause cancer in any way.”

Are mammograms painful?

It all depends. A 2020 study published in the journal Radiography found that during a mammogram, some people experience more discomfort than others. But there wasn’t a correlation between breast size, breast density, or total compression force and pain.

“The mammogram itself is not a painful procedure,” Vaidya explains. “The act of compression, which is an essential part of the mammogram to help flatten the breast so the X-ray can penetrate, can at times be uncomfortable.

However, the very awareness of why the compression is needed and how this helps the doctor’s get better imaging to rule out any early scan of cancer can be comforting and help ease any worries.”

In situations where her patients find the compression pain unbearable, she advises them to take some anti-inflammatories like ibuprofen 30 minutes before the procedure. “Some women also find that engaging in some deep breathing exercises prior to the procedure can also help mitigate the pain,” she adds.

How can I prepare for my mammogram?

Aside from popping a pain reliever before your appointment, here are a few things you can (or, in some cases, have to) do:

Skip the deodorant, lotions and similar products

When you made or confirmed your appointment, the office likely (or at least should have) told you not to wear deodorant, lotions, oils, powders or perfumes when you come in for a scan, as these products can show up as white spots on the X-ray.

Opt for pants or a skirt

If you’re someone who regularly wears dresses, you might want to plan another outfit for the day of your appointment. Because you have to be topless, at least if you wear a skirt, slacks or other bottoms, you’ll have something on your lower-half.

Book your appointment for after your period

“The phase of your menstrual cycle does not affect the accuracy of your mammograms,” Dr. Habib Rahbar, clinical director of breast imaging at Seattle Cancer Care Alliance tells Lifehacker. So don’t worry about that. But if you tend to get sore or tender breasts before and/or during your period, Vaidya recommends booking an appointment around seven to 10 days after the start of menstruation.

Bring documentation if you’re new

If this is your first visit to an imaging centre, bring a list of the places and dates of mammograms, biopsies or other breast treatments you’ve had before, so all that information is handy if you need it.

What happens during a mammogram?

First of all, the boob-squishing portion of your appointment usually only takes around 10 minutes, and the actual breast compression only lasts a few seconds each time. Of course, there are a bunch of other parts of your appointment, but it may help to know that the imaging is pretty quick.

Everything starts with taking your clothes and undergarments off from the waist up and donning a breezy hospital gown. (If you happen to have large breasts and usually have trouble closing a normal hospital gown, know that many imaging centres offer the gowns in a variety of sizes.) We’ll let the CDC take it from here:

You will stand in front of a special X-ray machine. A technologist will place your breast on a plastic plate. Another plate will firmly press your breast from above. The plates will flatten the breast, holding it still while the X-ray is being taken. You will feel some pressure. The steps are repeated to make a side view of the breast. The other breast will be X-rayed in the same way. You will then wait while the technologist checks the four X-rays to make sure the pictures do not need to be re-done.

The technologist can’t tell you the results of your mammogram, but they do take the images to the doctor (a radiologist) to take a look and see if there’s anything that needs a closer look. In some cases you’ll be asked to stay for an ultrasound, but if you don’t need one, that’s it — you go on with your life, and usually within about a week to 10 days, the radiologist will send your official results to you and your general practitioner.

What happens if I need an ultrasound?

Sometimes, the radiologist will take a look at your mammogram and want to get some more information. If this happens, don’t panic. There are several reasons why getting the a more detailed look at your breasts and their blood flow might be necessary. These include:

  • Having dense breast tissue, which can make it hard to get a clear picture solely via the X-ray.
  • For some other reason, the X-rays weren’t clear or left parts of the breast out.
  • There’s one part of your breast where the tissue looks different.
  • The radiologist spotted calcifications or a mass (which could be a cyst).

Typically, you get the ultrasound results that day and either get the all-clear, are asked to come back in six months for a follow-up, or are told you need to schedule a biopsy for further testing (and it’s important to know that a biopsy order doesn’t automatically equal cancer).

If I know I have dense breasts, do I still have to do the X-ray part?

If, after your first mammogram, you find out that you have dense breast tissue and need an ultrasound, you may wonder if this means you’re done with the squishing X-ray forever. Sorry, nope.

“A common myth is that mammograms are not helpful in women with dense breasts,” Rahbar explains. “While mammograms can find less cancers in women who have dense breasts, they are still valuable and do catch many cancers. You should continue to get mammograms, especially those with ‘3D’ or ‘tomosynthesis’ technology when available, regardless of your breast density.

What does a mammogram feel like?

For some people, mammograms are no big deal. But for others, they’re a major source of anxiety and physical pain (or at least discomfort). There are a lot of different factors at play here, including your personal pain tolerance and the type of equipment that’s used, so just because you had a friend who had a bad experience, that doesn’t mean it’ll be the same for you. Here’s some more insight from people who’ve been through it.

What it feels like to be a ‘topless contortionist’

“After your first mammogram you will be able to answer your lifelong question of what it would feel like to be a topless contortionist. But working a mammogram into your yearly rotation of wellness visits doesn’t have to be as daunting as you envision it. Remember your first visit to the gynecologist? Your first trip to the dentist? If you put it in your mind that your yearly boob smoosh is as routine as your yearly pap smear, when that appointment reminder goes off, you and your boobs will be ready.” — Meredith Goldberg, author of From Cocktails to Chemotherapy: A Guide to Navigating Cancer in Your 30s.

Size matters

“My personal experience was definitely full of the unknown combined with anxiety, because I was diagnosed with breast cancer a few days after my latest mammogram in July 2020. I’m honestly still in denial and praying for the day I become cancer-free. I believe everyone’s experience can be different when they get their mammogram because our bodies are different. I also feel the size of your breasts play a role in how the process feels — especially if you have implants like I do!” — Sonya Dalton-McRoberts, celebrity trainer, former professional basketball player, and founder of Total You By Sonya D.

Uncomfortable but routine

“My mammograms were routine. Somewhat uncomfortable, but they were routine. Feelings of worry and anxiety were always the backdrop, partially because I knew the stat that 1 in eight women get breast cancer, and also because I knew I had fibrous breasts, which mean sonograms and further exploration. Not to put fear into anyone, but while mammograms may be uncomfortable, getting chemo infusions every other week is way more uncomfortable. By getting a mammogram, you are being proactive and taking care of yourself. Self care needs to be celebrated!” — Tina Zaremba, voice actor and host of the Chemo Stories podcast.

Lesser-Known Breast Cancer Facts You Should Know

Photo by Pablo Heimplatz. It’s breast cancer awareness month, but I think we’re already aware that breast cancer exists and that mammograms can detect it. So as long as we’re surrounded in pink, let’s take a look at some important facts that actually need a little more awareness:

Read more

Tips for improving your mammogram experience

Though you’ll probably never get to the point of enjoying mammograms, there are a few ways to make them more bearable. Here are some tips from experts who do mammograms for a living, as well as from others with personal experience.

Avoid caffeine

As much as you love/need your morning cup(s) of coffee, you may want to skip caffeinated beverages the day of your mammogram. “This trade off might not be worth it for many women, but caffeine consumption can increase sensitivity,” Jennifer Cantu RT(R)(M)(CT), a registered technologist and clinical specialist at Volpara Health tells Lifehacker.

Stay off the internet

A quick scroll on Instagram while you’re waiting for your appointment can quickly lead to a search for “mammograms and cancer,” and before you know it, you’re cancer doomscrolling, Goldberg says. “Bring a book, read a magazine, or watch whatever TV they have on in the waiting room,” she advises. “Sometimes you get lucky and they have The Golden Girls on loop!”

Go with a friend

If you don’t want to go alone, enlist a friend to be your mammo-partner. “Some friends make it a celebration, scheduling back-to-back mammograms each year, followed by a celebratory lunch,” Cantu says.

Give yourself enough time

Though the procedure itself may be quick, the whole process can take a while. Instead of assuming you’ll be able to squeeze a mammogram in during your lunch break, Goldberg suggests giving yourself plenty of time for the appointment — rushing will just make you more anxious.

Don’t keep putting it off

If you’re nervous about getting your mammogram, make the appointment if you’re due for one — even just knowing that part is done might help with your anxiety. “Just remember that by getting a mammogram, you are taking an important proactive step to living longer and healthier,” Rahbar says.

Focus and breathe

Your mind may be racing, but try to stay in the moment. “You are where your attention is,” Zaremba says. “Focus on what you are grateful for and breathe. These mammograms save lives.”

Be vocal

It is completely appropriate — and encouraged — to ask as many question as you need to during your appointment. “Even if you think it’s the most trivial of questions, the nurses and radiologists are there to help guide you,” Goldberg says. “So if you want to know the difference between a 3D mammogram and a conventional mammogram, ask someone — don’t just Google it when you get home.”

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