7 Mammogram Myths You Might Still Believe

While it remains the second deadliest cancer among American women, the rate of breast cancer deaths has dropped dramatically—almost 40 percent—since 1989. A combination of factors may be responsible. These include increased awareness, advances in medical treatment, and the widespread use of screening mammograms.

When people have mammograms, they help identify nearly four out of five cases of breast cancer, sometimes years before being felt. Yet, despite their strong track record, regular screenings are often skipped due to misunderstandings about how they work, how much they cost, or why and when they’re needed.

“There are still a lot of misconceptions there,” says Paula Y. Rosenblatt, MD, a medical oncologist at the University of Maryland Greenebaum Comprehensive Cancer Center in Baltimore. “But I think better breast awareness and understanding has helped the situation.”

Here are the biggest breast-screening myths, along with the facts behind them.

While any lump or change in the feeling of your breast should send you to a doctor pronto, breast cancer could be there for years before you’re able to feel it. That’s why having regular mammograms is so important: They can help find, diagnose, and treat cancer before signs are more evident. “A vast majority of breast cancers are now detected without any symptoms,” says Dr. Rosenblatt.

Research has found that discovering breast cancer early, before it advances, can increase quality of life and chances of survival. Between 2009 and 2015, the five-year survival rate for localized breast cancer—cancer that hasn’t extended beyond the breast—was about 99 percent, according to the National Cancer Institute. When the cancer was classified as distant, meaning it spread to other parts of the body such as the liver and lungs, the five-year survival rate dropped to 29 percent.

Studies have found no significant benefit to physical breast exams for detecting cancer, including clinical exams done by healthcare providers (HCPs) and self-exams performed at home. In fact, the U.S. Preventive Services Task Force (USPSTF) recommends that HCPs refrain from teaching patients how to do self-exams.

Mammograms, instead, are much more reliable for finding the disease. “We know from studies that mammograms can pick up significantly earlier, smaller cancers and that improves outcomes,” Rosenblatt says. Never use a physical exam in place of a mammogram.

That said, you should know the normal appearance and feel of your breasts. This way, you can recognize sudden changes and bring them up with your HCP as soon as possible.

Although many HCPs advise starting screening mammograms at 40, the age at which to begin having mammograms and how often to get them are matters of considerable debate. Different organizations offer different guidelines for women at average risk for breast cancer:

• The USPSTF recommends that women between the ages of 50 and 74 get a mammogram every other year. From age 40 to 49, it’s an individual choice about when to begin screening.
• The American College of Obstetricians and Gynecologists (ACOG) advises that HCPs offer mammography to women starting at age 40. From then until age 49, an individual can choose when to begin screening, though all women should start by 50. ACOG recommends getting a mammogram annually or biennially once you start.
• The American Cancer Society recommends women have annual mammograms from age 45 to 54; they can switch to every two years after that. From 40 to 44, it’s a personal decision.
• The American College of Radiology and National Comprehensive Cancer Network recommend every woman begin yearly screenings at age 40.

Women at higher risk should always confer with their HCP, as they may need to begin mammograms earlier and have them more frequently. Your HCP can use several assessment tools to help determine if you’re in this category.

Mammograms are rarely described as a walk in the park. “Some patients do experience some mild discomfort,” confirms Rosenblatt.

But the pressure on each breast is very brief—only long enough to take quick images—and many women recount the feeling as temporarily unpleasant, rather than outright painful. (If the compression does become too much to bear, alert your technician.)

Worried about potential soreness? Try to avoid scheduling your appointment when your breasts are tender, like in the days before or during your period. Rosenblatt suggests that taking an over-the-counter pain reliever could help, as long it’s safe for you. And if it’s your first mammogram, she recommends asking the technician to walk you through the process, “because the stress and tension also makes it more uncomfortable for patients.”

Since they involve X-rays, mammograms expose you to some radiation, but the amount is strictly regulated and “remarkably low,” says Rosenblatt. It’s similar to what you receive from the environment in about seven weeks.

What’s more, the benefits of mammograms outweigh the harms of radiation. That means the potential hazard of low-dose radiation exposure is minimal compared to the upside of detecting breast cancer early.

Maybe the first images weren’t clear enough. Maybe your breast tissue is denser than average. Maybe part of your X-ray just looks a little different from the rest. Whatever the issue, if your imaging team needs another look at your breasts, you’re getting called back into the office.

And you’re hardly alone. It’s estimated that up to 16 percent of women who undergo their first mammogram are called in for more testing, for various reasons. The rate is higher for pre-menopausal women, and a 2016 review in JAMA suggests that more than half of women who have annual mammograms will get a call back at least once in their lifetime.

The additional assessment could involve a diagnostic mammogram—where further images are taken—or another test, like an MRI or an ultrasound. Some patients will need a biopsy, or a tissue sample, for further analysis. The good news is that more than 9 out of 10 times, people who are called back are cancer-free.

Waiting for any medical test results can be nerve-wracking, but it’s important to remember that callbacks are common and normal—and so are your feelings about them. Call your HCP or the American Cancer Society at 1-800-227-2345 if you have questions or need support.

If you have health insurance and worry about paying for a screening, you can breathe easy. For women over 40, the Affordable Care Act requires private plans and state Medicaid expansions to cover screening mammograms every 1 to 2 years—no copayment or coinsurance necessary. Medicare pays for annual screening mammograms, as well.

Before scheduling your mammogram, contact your insurance company to find out if it will be covered; some newer 3D mammograms may not be. It’s also important to note that screening mammograms are different from diagnostic mammograms, which often aren’t fully covered.

What if you don’t have health insurance? Organizations like the National Breast Cancer Foundation, the National Breast and Cervical Cancer Early Detection Program and the Susan G. Komen Foundation frequently partner with local imaging centers to provide free and low-cost screenings to eligible women. Visit their websites or speak with a facility representative for more information.

In the event you are diagnosed with early-stage breast cancer, the treatment may be less intense and less expensive than for cancer at a later stage. An ounce of prevention could save you a lot of money, time, anxiety—and your life.