Mammography—a screening test used to detect breast cancer—is not a new technology: It has its roots in the first half of the 20th century, and the American Cancer Society first officially recommended it in 1976.

Over the years, the machines and the guidelines on screening have changed, but one thing remains: the discomfort of having the test.

Some patients experience anxiety about having the exam. Others find the experience itself quite painful, as it involves compressing the breast between two plastic plates to get an X-ray of all of the breast tissue. (In one study, 35 percent of those interviewed reported discomfort, and 6 percent reported pain.) 

More About Breast Cancer Screening

The machine compresses your breasts for a reason: It helps doctors get a more accurate image while using less radiation than a regular X-ray.

Still, “for many women, these mammograms are not pleasant,” says Mamta Kalidas, M.D., medical editor at the American Cancer Society and an assistant professor of hematology and oncology at the Baylor College of Medicine.

We consulted clinicians, experts, and the research and found there are a number of concrete things you can do to make the experience smoother and more comfortable. 

Scheduling Your Exam

  • Don’t schedule your exam for when your breasts will be especially tender—like when you menstruate. “One of the things [that] can help to minimize pain is to not have your mammogram the week before your [period],” Kalidas says. The week after your period, she says, may be the best time to schedule it.

  • If you’ve had mammograms before, it's best to return to the same clinic whenever possible. If you are going to a new clinic, make sure the new facility has the films from any previous exams so that the radiologist can compare the new pictures to the older ones. (If you’re getting a mammogram for the first time or there are no old pictures to compare the new ones to, the clinic may need to take a few pictures more than the standard two views of each breast.)

  • If you use a wheelchair or scooter, call in advance to make sure that the mammography room is accessible, says Helen Barr, M.D., director of the Food and Drug Administration's Division of Mammography Quality Standards. Also, ask if you will need to schedule two appointment slots to give you more time during the mammogram, or if you will need the help of two technologists to get into position.

Preparing for Your Appointment

  • Avoid coffee and tea the day of your exam, suggests Dana Aragon, R.T.(R)(M), a mammographer and chief governance officer of the American Society of Radiologic Technologists. The Mayo Clinic notes that lowering or eliminating caffeine intake may be helpful to reduce breast pain, although research on the subject is not conclusive. 
  • “Because you will have to remain perfectly still during the exam, wear flats or other comfortable shoes,” Aragon says. You may also want to wear a two-piece outfit, rather than a dress or jumpsuit, she suggests, so that you can stay in your own clothing from the waist down.
  • On the day of your exam, don’t put deodorant, powder, lotion, or perfume under your arms or on your breasts, the FDA advises. The metallic particles in some of these products could show up on the image, according to the Mayo Clinic, which could lead to confusion or additional scans.
  • Ask your regular doctor whether it’s safe for you to take an over-the-counter pain reliever like ibuprofen (Advil and generic), acetaminophen (Tylenol and generic), or naproxen (Aleve and generic) before the exam, suggests Kalidas. These everyday medicines can prevent discomfort and won’t affect the image. 

At the Clinic

  • Consider meditating or listening to soothing music in the waiting room. During the mammogram itself, you might not be able to do so, as you’ll need to pay attention to the technologist’s instructions.
  • Ask any questions you may have. Technologists will usually explain step by step what’s about to happen, but if you’re feeling nervous, feel free to ask questions.
  • Listen carefully to the instructions. To get an image of all of your breast tissue, the staff at the clinic may need you to step closer to or farther from the machine and lift your arms a certain way. If a picture doesn’t fully capture your breast tissue and you have to redo it, Kalidas says, “it’s not necessarily anybody’s fault.” That said, if you listen closely, it may help you get into position faster and avoid additional breast compression. “Once they can get you in the exact right position, then you can take the picture and be done,” she adds.
  • “Tell the clinic if you have physical disabilities that may make it hard for you to sit up, lift your arms, or hold your breath,” the FDA suggests. “Experienced mammography technologists have things they can do based on the disability, such as pillows for the arms or behind the back depending on the individual situation,” Barr says. If you have a frozen shoulder or other issue moving your arms, the technologist will adapt, says Stamatia Destounis, M.D., a radiologist and clinical professor in the department of imaging sciences at the University of Rochester Medical Center. To help you stay comfortable, she says, “we change the position of the X-ray tube, not the patient.”
  • Let the clinic know if you have breast implants, as the technologist may need to take a few more images. That goes for any patient who has them, says Madeline Deutsch, M.D., M.P.H., an associate professor and the director of transgender care at University of California–San Francisco: If the implants happen to relate to your gender identity, you don’t have to disclose that fact. (“The common factors that transgender people have that could impact mammography,” Deutsch says, occur in many other patients as well, and include “implants, underdeveloped or dense breasts, or, in the case of transgender men, possibly not enough tissue to fit between the plates.")

After the Mammogram

You may be worried after your exam about when you’ll get the results and what they might say, Kalidas says. For screening mammograms, you should hear results within 10 days. If you haven’t, make sure to call your doctor or the facility.

Clinics are also required to mail you “an easy-to-understand summary” within 30 days, or “as quickly as possible” if the results do suggest the presence of cancer, according to the American Cancer Society. You also have the right to ask for a copy of the films if you want them for any reason, or if you need them to bring to another clinic.

“Don’t be alarmed if you’re called back for further testing,” Aragon says. “Sometimes doctors just want to confirm that what they’re seeing is harmless.” Dense breast tissue or a cyst can require a closer look, for example. 

Mammography is not infallible, Kalidas says, but it is still relatively effective for detecting cancer—so the technology probably won’t be changing anytime soon, even if it does cause pain and discomfort in some patients.

Research has suggested smaller steps clinics could be taking to decrease discomfort during exams, but so far none have been widely adopted. For instance, one study showed that topical lidocaine gel can ease the pain of mammograms—yet Kalidas says she’s never seen it in practice. Another study suggested that less compression could be just as effective, and presumably less uncomfortable for the patient.

In the end, Kalidas says, keep in mind that while the appointment and getting into position may last around 20 minutes, “the actual compression only takes a few seconds.” That, she adds, is “at least a little comforting.”