Quick answer: a mammogram is a low-dose x-ray of the breasts. A technologist places each breast on a platform and gradually presses it with a clear plastic paddle while two pictures are taken of each side. It can be uncomfortable, and for some women briefly painful, but the pressure lasts only a few seconds per picture, and you can always ask for less. The whole visit takes about 30 minutes. Don’t wear deodorant, powder or lotion, and try to book it about a week after your period. The USPSTF recommends a screening mammogram every two years from age 40 to 74; the American College of Radiology recommends yearly screening from 40.
«Does it hurt?» is the first question almost every woman asks before her first mammogram. The honest answer is that it varies from person to person, and there are simple ways to make it easier.
What is a mammogram?
A mammogram uses a specialized x-ray machine to see inside the breasts. It can show changes years before you or your doctor could feel them.
- Screening mammogram: for women with no breast symptoms, to find cancer early, when it is most treatable.
- Diagnostic mammogram: for women with a lump, pain, skin dimpling or nipple discharge, or to look more closely at something seen on a screening mammogram.
Most U.S. centers use digital mammography, and many offer 3D mammography (breast tomosynthesis), in which the x-ray tube moves in an arc over the breast to build a 3D image. 3D mammography finds more cancers and leads to fewer callbacks. See [link: 3D Mammogram vs 2D: Is It Worth the Extra Cost?].
Does a mammogram hurt?
You will feel pressure as the paddle compresses your breast. Many women describe it as uncomfortable rather than painful; women with sensitive breasts may feel more discomfort. The pressure only lasts a few seconds for each picture.
Why the squeeze is necessary: compression evens out the breast so all the tissue can be seen, spreads it out so small abnormalities are not hidden, allows a lower x-ray dose, keeps the breast still to avoid blur and makes the images sharper.
How to make it more comfortable:
- Book the right week. Avoid the week before your period if your breasts are usually tender; the best time is about one week after your period.
- Tell the technologist if it hurts as the pressure increases. They can use less compression if the discomfort is significant.
- Breathe and relax your shoulders. Tension in the chest muscles makes positioning harder.
From the scanner room: [TU EXPERIENCIA: o mejor, de una técnica de mamografía que conozcas: cómo explica la compresión a las pacientes, qué hace con las que tienen mucho miedo y qué consejo práctico funciona mejor.]
How to prepare
- No deodorant, antiperspirant, powder or lotion under your arms or on your breasts on the day. They can show up on the images as tiny white spots that look like calcium.
- Wear a two-piece outfit, so you only need to remove your top. You will wear a gown.
- Bring previous mammograms if they were done elsewhere. Comparing with older images is very important.
- Tell the team about any breast symptoms, previous surgery, hormone use, breast implants, a personal or family history of breast cancer, or any chance you might be pregnant.
- Ask when you will get your results, and do not assume they are normal if you do not hear back.
Step by step
- Changing. You undress from the waist up and put on a gown.
- Positioning. A specially trained technologist places one breast on the platform and positions your arm and shoulder.
- Compression. The paddle presses gradually onto your breast for a few seconds.
- The picture. You hold still, and may hold your breath briefly, while the image is taken.
- Two views per breast. Usually one from above and one angled from the side. Then the same for the other breast.
- Checking. You may be asked to wait while the images are checked.
The whole exam takes about 30 minutes, but the compression itself only adds up to a few minutes.
If you have breast implants
Tell the facility when you book. Implants can hide some breast tissue, so extra views are taken, often with the implant gently pushed back. Experienced technologists know how to compress safely without damaging the implant.
When do you get the results?
A radiologist reviews your mammogram and sends a report to your doctor. The mammography facility will also send you a letter with your results. Your report includes your breast density: dense breast tissue can make cancer harder to see and is linked with a somewhat higher risk, and you will be told if your breasts are dense. See [link: Dense Breasts: What It Means and What to Do].
What if I am called back?
Getting called back for more pictures is common and usually not cancer. About 5% to 15% of screening mammograms need more testing, such as more mammogram views or an ultrasound, and most of these turn out to be normal. See [link: Called Back After a Mammogram: What Happens Next].
How often should you get a mammogram?
| Organization | Recommendation for women at average risk |
|---|---|
| U.S. Preventive Services Task Force (2024) | Every 2 years from age 40 to 74 |
| American College of Radiology and Society of Breast Imaging (2023) | Every year from age 40, with no upper age limit |
If you are at higher risk, for example because of a strong family history or a genetic mutation, talk to your doctor about starting earlier and about additional tests such as breast MRI. See [link: Breast MRI: Who Needs It and What to Expect].
Is the radiation safe?
Yes. A screening digital mammogram is about 0.28 mSv and a 3D mammogram about 0.34 mSv, roughly 5 to 6 weeks of natural background radiation. No radiation remains in your body afterward.
Tips from the technologist
[TU EXPERIENCIA: 2-3 consejos propios (o de una técnica de mamografía). Ideas: llevar la lista de fechas y centros de mamografías anteriores, no aplicar crema hidratante esa mañana, decir si una postura duele por el hombro o la espalda.]
Frequently asked questions
How long does a mammogram take?
About 30 minutes for the visit; the compression itself only lasts a few seconds per picture.
Can I wear deodorant to a mammogram?
No. Deodorant, powder and lotion can appear on the images. Many centers provide wipes in case you forget.
Is a mammogram more painful with small breasts?
Not necessarily. Discomfort depends more on breast sensitivity and the time in your cycle than on size.
Can I get a mammogram while breastfeeding?
Often yes, though the images can be harder to read. Tell the facility when you book.
Does Medicare cover mammograms?
Yes. Medicare covers screening mammograms, and most private insurers cover screening that follows USPSTF recommendations. See [link: Does Medicare Cover MRI and PET Scans?].
This article is for general information and does not replace advice from your doctor.