Getting a mammogram is never going to feel like a relaxing spa treatment. But should mammograms be painful? No. Fortunately, there are several ways to make the test less physically and emotionally uncomfortable.

No matter how nervous or even anxious you may feel about getting a mammogram, the screening is essential for the early detection of breast cancer, says radiologist Dana Bonaminio, MD, who specializes in breast imaging and image-guided procedures. “One in eight women will be diagnosed with breast cancer in her lifetime. Routine exams can reduce the mortality rate of breast cancer by 40 percent¹, and can detect the disease before it is large enough to feel or cause symptoms,” explains Dr. Bonaminio.

“Routine exams can reduce the mortality rate of breast cancer by 40 percent.” —Dana Bonaminio, MD

She says that early detection of breast cancer not only improves survival rates, but it can also make treatment easier and less expensive. Annual mammograms are the best way to stay on top of tumor growth so that they don’t go undetected and advance into later stages, making treatment more invasive.

To keep us all from shying away from the exam, here she shares the mammogram info everyone with breasts should know, as well as her best tips that can help make mammograms less painful—both physically and mentally.

What should you expect from a mammogram?

Part of the mammogram anxiety that many people experience has to do with simply not knowing what to expect. So Dr. Bonaminio walked us through the steps of a typical mammogram exam.

1. 1.
   When you get to the exam room, a mammography technologist will guide you into position on the machine to ensure that it captures the best images possible.
2. 2.
   Your breasts will be uncovered one at a time to take two images with the mammography device. One image will be of the top and bottom of the breast and the second from side to side.
3. 3.
   If you are getting a 3D mammography exam, the machine will move in an arc over your breasts, and you may be asked to hold your breath during this part of the exam.

“You’ll likely undergo compression about four times at several different positions and angles,” adds Dr. Bonaminio. “You may feel some discomfort during this, but the exam should not be painful.”

Dr. Bonaminio says that while a mammogram may seem intimidating, especially if you have never had one before, the whole process is very short-lived. “Mammograms are quick—a typical screening exam lasts about 20 minutes, with actual breast compression lasting about 10 to 15 seconds for each image,” says Dr. Bonaminio.

After your mammogram, a radiologist will review your images and be in touch with results within a few days, either by phone or mail.

“Getting called back for additional views is fairly common, especially after your first or baseline mammogram,” says Dr. Bonaminio. “Your radiologist may also send you a report about your breast density. If you discover that you have dense breasts, be sure to ask for a 3D mammogram or tomosynthesis, which allows for better cancer detection in dense tissue than a 2D mammogram.”

Should mammograms be painful?

While discomfort during a mammogram will vary from patient to patient, Dr. Bonaminio says that some women may find the compression and breast paddles used for a mammogram to be uncomfortable.

“Traditional compression paddles were designed to lay flat and were not inherently flexible, meaning that they did not follow the natural shape of the breasts,” explains Dr. Bonaminio. “Additionally, these devices do not always offer a uniform compression across the breast, which may lead to pain and pinching.”

Fortunately, mammogram equipment has advanced significantly—and these advancements have made the exam comfortable for most women. “Many of today’s systems feature curved compression paddles made of acrylic that contour to the breast to help reduce pinching,” says Dr. Bonaminio. “In fact, these curved breast paddles have been shown to improve comfort in 93 percent of patients who previously reported moderate to severe discomfort using standard mammography compression technology.”

She adds that some patients may feel discomfort during the mammogram when the technologist moves you through different positions and angles. Some of these movements may not feel natural, but Dr. Bonaminio says the various positions are necessary to capture the best images of your breasts during the exam.

“Don’t hesitate to tell your mammography technologist if something feels uncomfortable during an exam,” says Dr. Bonaminio. “They may be able to adjust your position and the machine’s compression to improve your experience.”

8 ways to make mammograms more comfortable

One key to having a positive mammogram exam experience is setting yourself up for success. Here are Dr. Bonaminio’s best tips:

1. 1.
   Wear a two-piece outfit (rather than a dress or jumpsuit) because you’ll need to remove your top and bra for the exam.
2. 2.
   Don’t be afraid to ask your technologist any questions you have during your exam. The mammogram tech can help explain all of the steps of the procedure and walk you through what will happen next.
3. 3.
   Schedule your mammogram one to two weeks after your period because the breasts tend to be most tender the week before and during menstruation.
4. 4.
   Take an over-the-counter pain medicine like acetaminophen or ibuprofen an hour before your mammogram to help reduce discomfort.
5. 5.
   Ask your technologist to use a curved breast compression paddle (if available), which can cut down on the pinching and discomfort.
6. 6.
   Ask for a breast cushion. The pad can cut down on compression pain because it will be placed between your breasts and the bottom plate of the machine.
7. 7.
   Tell your technologist if you’re experiencing discomfort. They may be able to adjust compression levels and help position you in a way that is more comfortable.
8. 8.
   Consider scheduling your mammogram exam around the same time as a friend’s so that you both have a built-in support system and can help hold each other accountable.

What to do if you’re anxious about getting a mammogram

While those at average risk will begin annual mammograms at age 40, everyone with breasts should start talking to their healthcare provider about screening by age 25, suggests Dr. Bonaminio. “Some patients may be considered high-risk due to a family history of breast cancer, dense breast tissue, or other factors,” she says. The important thing is not to let nerves keep you from making the appointment.

“Try to view your mammogram as a regular health checkup, like a dental cleaning or annual physical. The exam is a crucial tool for improving your health in the long run,” says Dr. Bonaminio. “You can also create a list of questions to ask your healthcare professional or mammography technologist to take away some of the unknowns about the exam.”

Simply put, early screening saves lives. “Annual screening mammography remains our best tool in the fight against breast cancer,” says Dr. Bonaminio. “Being your own advocate and taking an active role in your breast health is empowering!”