Does it hurt? How do you prepare? With a family history of breast cancer and a doctor urging her to get a baseline screening, journalist Lauren Oster made an appointment with a radiologist. Here's her take on what to expect when you go for this crucial test.

August 07, 2017

As a health reporter, I pay attention to the latest news about mammograms. In the last few years, as guidelines and recommendations on how often women should have them and when they should begin to do so have changed, keeping up on those details has felt like a larger and larger part of my job.

As a 38-year-old woman, on the other hand, I've had little personal experience with this imaging tool, which takes X-ray photos of each breast to screen for possible signs of breast cancer.

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That changed following a recent checkup with my gynecologist, when I mentioned that my father had just undergone BRCA gene mutation testing after two of his sisters were diagnosed with breast cancer. He doesn’t have the mutation, but my doctor felt that it was time for my first mammogram, given this development in my family history.

She jotted down a referral, gave me the name and number of a local radiology center, and told me to schedule an appointment for the week after my period (when, she explained, my breasts would be least likely to be tender and the screening should be a little easier).

I knew, as the National Cancer Institute has reported, that research has yet to show a benefit from baseline screening mammograms for women my age. That said, my insurance company would pay for the cost of my imaging, which is always covered for women age 40 and above, though that isn't necessarily the case for women in their 30s.

I was also comfortable with the idea of being exposed to radiation. As the American Cancer Society notes, the dose used to screen both breasts is about what a woman would be exposed to in her usual environment in seven weeks. So I decided to take my doctor’s advice.

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I’d always thought that a mammogram, like an ob/gyn checkup, was something I’d have to book long in advance. Not so, at least in New York City, where I live. I could come in as soon as I was ready, the receptionist said. “Now, don’t wear deodorant, talcum powder, or fragrance to your appointment,” she instructed me.

I knew the reason why. Metallic particles in personal products can show up in mammograms and appear as abnormalities in breast tissue. If you’re not comfortable with the idea of going without deodorant or perfume for hours while you wait for your appointment, you can always schedule your mammogram in the morning, and bring deodorant to apply once you’re through.

Though I had the luxury of knowing my doctor didn’t expect any abnormalities to show up in my mammogram, I prepared for my appointment with something like sadness. Everyone’s body betrays them one day, of course—that’s how mortality works. But I felt that I was being especially accusatory with part of mine. From here on out, I guess my main concern with my breasts is whether or not they’ll hurt me, I thought. I pulled on an embroidered blouse I’d just bought on vacation, as if I were dressing for a blind date with myself.

That blouse was a lucky choice. Because I was wearing a two-piece outfit when I arrived at the radiology center, I was able to leave my shorts on for the mammogram itself. (Skip the sundress if you don’t want to face your scan in nothing but underpants; as long as your top is off, you can keep everything else on.)

As my tech helped me prepare, to my surprise, I gained some temporary hardware: She applied disposable stickers with tiny metal BBs to my nipples to mark their location, which would help her determine if my breasts were positioned properly during the image captures.

My tech asked if I had any scars or moles that she should mark with additional stickers, so that the radiologist who reviewed my film wouldn’t confuse them with lesions. I explained that I’d had mastitis scarring as a baby, and she erupted in laughter. “Babies can have mastitis? I’m six months pregnant”—she gestured to the curve of her own belly—“and hadn’t even known to worry about that yet!” You’re welcome, radiology tech. (Mastitis in babies is rare, for what it’s worth.)

Now that I’d been prepped, it was time for the shoot. The mammogram machine itself felt like a particularly intimate blood pressure cuff; to be honest, the blood pressure reading my gynecologist had taken a few weeks earlier had been more uncomfortable.

My tech positioned and compressed each of my breasts on the machine’s plates as I gripped its handle and held my breath; the dreaded squashing took about 10 seconds for each of the two images she took per side (the usual for screening mammograms). I was in and out in a few minutes, and then I was back in my shirt and on my way home.

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That said, depending on the size of your breasts, the experience of the actual mammogram might be a little rougher. Some women, particularly those with small or dense breasts, find their mammograms more painful. If you’re worried about discomfort, consider taking an over-the-counter pain reliever about an hour beforehand, and know that no matter what, the procedure will be over quickly.

Two weeks later, I received a letter from the radiology center letting me know that I had dense breast tissue. That's not unusual for women my age, but it means I have a slightly increased risk of breast cancer and that my mammograms may be less accurate. Otherwise, my results were normal. The center didn’t include any images, so I went online to see what other normal mammograms look like.

An X-ray image of a breast is strangely serene. It’s not really identifiable as a part of a human body, in the absence of context, and more like a snapshot of the night sky—a northern hemisphere, as it were. Researchers have spent decades and billions of dollars trying to make sense of those constellations, and I’m rooting for them to read more and more in them every day. I also know how lucky I am to be able to simply think of mine—for now, at least—as sky.