A mammogram takes just a few minutes and can find breast cancer years before it can be felt. Yet many women put off screening because they are worried about pain, embarrassment or bad news.
Imagine an invitation for breast screening sitting on the kitchen counter for weeks. You are busy, you feel fine and you have heard it hurts. Your friend’s cancer was found on her first mammogram, when it was tiny and treatable.
What a mammogram is
A mammogram is a low-dose X-ray of the breasts. It can show changes too small to feel, such as tiny clusters of calcium (microcalcifications) or small lumps, which may be early signs of breast cancer.,Mammograms are used both for screening women without symptoms and for investigating breast symptoms such as a lump. Screening and diagnostic mammograms are done slightly differently.
Who is offered screening
- Screening ages differ by country
- In England, women aged 50 to 71 are invited every three years
- In the US, the US Preventive Services Task Force recommends screening every two years from age 40 to 74
- Women at higher risk, for example because of family history or certain gene changes, may start earlier or have additional MRI scans
- Trans and non-binary people may be eligible depending on their circumstances; check with your healthcare provider
Before your appointment
- Wear a top and trousers or skirt rather than a dress, so you only need to undress from the waist up
- Avoid deodorant, talcum powder or lotion on your breasts and underarms on the day, as they can show on the X-ray
- Tell the staff if you have breast implants, are pregnant or breastfeeding, or have had breast surgery
- If your breasts are tender before a period, you may prefer to book at a different time of the month
What happens during the mammogram
A female mammographer usually carries out the test. You stand in front of the machine, and each breast in turn is placed on a flat plate and pressed firmly from above by another plate for a few seconds. Two pictures are usually taken of each breast, from different angles.,The whole appointment usually takes about 15 to 30 minutes, with the compression lasting only seconds each time.
Does it hurt?
Most women find it uncomfortable rather than painful, though experiences vary. The pressure flattens the breast to get a clear picture with the lowest radiation dose. If it hurts, tell the mammographer; they can adjust things. Some women find it helps to take a simple painkiller beforehand, if suitable for them.
Being called back
About 4 in 100 women screened are called back for further tests, though this varies between countries and age groups. Being called back can be frightening, but most women recalled do not have cancer.,Further tests may include more mammograms, an ultrasound scan, or a biopsy, where a small sample of tissue is taken with a needle under local anaesthetic.
Benefits and limitations of screening
Screening reduces deaths from breast cancer by finding cancers early, when treatment is more likely to be successful and less extensive.,However, screening also has limitations. It can miss some cancers, particularly in dense breasts. It can also find cancers that would never have caused harm in a woman’s lifetime, leading to treatment she did not need; this is called overdiagnosis. Most programmes provide information to help you make an informed choice.
Breast awareness between screens
Screening does not replace knowing your own breasts. See a healthcare provider promptly if you notice a new lump or thickening, a change in size or shape, puckering or dimpling of the skin, nipple changes or discharge, a rash around the nipple, or ongoing pain in one area. Do not wait for your next screening appointment.
Breast cancer around the world
Breast cancer is the most commonly diagnosed cancer in women worldwide. Survival is much higher where cancers are found early and treatment is available quickly. In many low- and middle-income countries, cancers are more often diagnosed at a late stage, which is why awareness of symptoms and access to diagnosis matter so much.
The World Health Organization’s Global Breast Cancer Initiative aims to reduce deaths by promoting early detection, timely diagnosis and complete treatment.
Men can get breast cancer too
Breast cancer in men is rare but does happen, usually in older men. Signs include a lump behind the nipple, nipple changes or discharge. Men are not offered routine screening, so any change should be checked by a healthcare provider promptly.
If you are worried about pain or anxiety
- Tell the mammographer at the start if you are nervous
- Ask them to explain each step
- Breathe slowly and relax your shoulders
- Remember the compression lasts only a few seconds each time
- You can ask to stop at any point
Frequently asked questions
Is the radiation dangerous?
The dose is very low, and for women in screening age groups the benefits are considered to outweigh the small risk.
Can I have a mammogram with implants?
Yes. Tell the staff, as special techniques are used.
What does dense breast tissue mean?
Dense breasts have more glandular tissue, which is common and normal but can make cancers harder to see. Some women are offered additional imaging.
But I have no family history. Do I still need screening?
Yes. Most women diagnosed with breast cancer have no family history. Age is the biggest risk factor.
Your next step: If you have a screening invitation waiting, book your appointment this week.
Related: What to expect from a biopsy
Sources: NHS Breast Screening Programme, US Preventive Services Task Force (2024), World Health Organization, Cancer Research UK.
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