5 Reasons Women Skip Mammograms—and Why You Shouldn’t

Content medically reviewed by Johnathan Valesano, MD

If you are age 40 or older and at average risk of breast cancer, getting an annual mammogram should be an essential part of your health care routine. Mammograms can detect cancer in its early stages, long before it can be felt, which is when it is most treatable. Yet according to a Centers for Disease Control and Prevention (CDC) survey, 1 in 4 women between the ages of 50 and 74 had not gotten a mammogram in the last two years.

“A screening mammogram is the best tool we have for detecting breast cancer early,” said Johnathan Valesano, MD, a radiologist, at Essentia Health. “There are many reasons why some women decide to skip their annual breast cancer screening. You are taking vital steps toward protecting your health by staying informed and prioritizing scheduling your mammogram every year.”

Here are some common reasons why many women forgo mammograms—and why you shouldn’t.

Fear of Pain

You might put off getting a mammogram because you have not had one before and you’ve heard that it’s painful. Or maybe you had one in the past that was uncomfortable.

The experience of getting a mammogram is different for everyone. Some women describe them as painful, while others only have minor discomfort. Additionally, just because you had one mammogram that caused pain, that doesn’t mean you will have the same experience the next time.Several factors affect your mammogram experience, including –

• Whether you have any pain before having the mammogram
• Hormone fluctuations that increase breast sensitivity
• Your breast size
• Fear or anxiety

“It can help to talk to your technologist about any concerns you have,” Dr. Valesano said. “You can also try to schedule around your period, when your breasts may be more sensitive. Try not to schedule the week before or during your period. Over-the-counter pain medications can also help.”

If you do experience pain, remember that mammograms are done relatively quickly. You will stand in front of the mammogram machine, and the technologist will position your breast on the machine. A plate will be lowered and compress your breast for 10 to 15 seconds. This process will be repeated several times, but any discomfort will only last while your breast is being compressed.

No Family History of Breast Cancer

Another reason you might not prioritize getting your annual mammogram is the belief you are not at risk because you have no family members with breast cancer. But only 5% to 10% of people diagnosed with breast cancer are believed to have a hereditary form of the disease.

Many factors affect breast cancer risk, including –

• Age. Your risk increases as you get older.
• Being born female. Breast cancer is significantly more common in women than in men.
• Dense breast tissue. Those with dense breasts are at a higher risk for breast cancer. Dense breast tissue, which is more glandular and fibrous than fatty tissue, also makes it more difficult for abnormal areas to show on mammograms.

Lifestyle factors can also affect your risk, such as –

• Drinking alcohol
• Being of higher weight
• Lack of physical activity
• Using certain hormonal birth control methods, including oral progestin-only and combination progestin and estrogen pills, injected progestin, and progestin intrauterine devices (IUDs)

These are just some of the factors that can influence breast cancer risk. Talk to your health care provider about your personal risk factors.

Reliance on Breast Self-Exams

While breast self-exams can help in the early detection of breast cancer, they should not replace screening mammography. This is because a mammogram can often show masses before you can feel them.

“While you should not rely on breast self-exams instead of breast cancer screening, being familiar with the way your breasts look and feel is still a good idea,” Dr. Valesano said. “This allows you to notice any subtle changes that could indicate a potential issue.”

Let your provider know if you notice any changes that concern you, such as a new lump, nipple discharge, or changes in breast appearance.

Cost of Mammograms

According to a recent CDC study, cost is one of the top reasons women don’t get annual mammograms.

For women 40 and older, most insurance companies cover screening mammograms at no cost to members every one to two years. Additionally, the CDC offers the National Breast and Cervical Cancer Early Detection Program, which provides free or low-cost mammograms to qualifying women who are uninsured, underinsured, or have low incomes. If you are uncertain about your coverage, check with your health insurance provider.

Fear of Results

For some women, fear of mammogram results or getting called back might keep them from getting a mammogram. But even if you are called back for additional imaging, it does not mean you will be diagnosed with cancer.

“Those who need additional tests after a screening mammogram often assume this means they have breast cancer. But fewer than 10% of people who get called back are diagnosed with cancer,” Dr. Valesano said. “In the event you are diagnosed with cancer, early detection can lead to much better outcomes, which is why it’s important not to skip your regular screening.”

There are many reasons why you might be called back after a screening mammogram, such as –

• The results were not clear, or the images missed some of the breast tissue, so they need to be taken again.
• The radiologist sees a mass or calcification and wants a closer look.
• The radiologist sees an area that looks abnormal compared to other areas of breast tissue and wants to take more pictures.

If you need a follow-up appointment, you will likely have a diagnostic mammogram, which will take additional pictures of any areas of concern. In some cases, you may also need additional imaging, such as a breast ultrasound.

Most often, follow-up imaging reveals that a suspicious area is not cancer, and you can return to your normal mammogram schedule. Sometimes, your provider might want to watch the abnormal area over time and recommend another mammogram in six months. You might need a biopsy to confirm a diagnosis if the area appears cancerous.