Mammogram Guide: When to Start, What It Feels Like, and Cost

Watercolor illustration of a woman undergoing a mammogram screening using a medical imaging machine.

A mammogram is an X-ray picture of the breast that can find breast cancer early, often before you can feel a lump. The appointment is short, but many women delay it because of worry about pain, cost, or the result. Knowing what really happens makes it easier to book.

This article explains who should get a mammogram and how often, what to expect at the appointment, what to do about common worries, and what a callback usually means. For other tests by age, see Preventive Screenings: What You Actually Need and When.

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Quick Answer

The U.S. Preventive Services Task Force recommends a screening mammogram every 2 years for women aged 40 to 74 who are at average risk of breast cancer (1). Most people who are called back for more pictures do not have cancer (2). Most insurance plans must cover screening mammograms with no copay (2).

Who Should Get a Mammogram and How Often

The 2024 Task Force recommendation covers women aged 40 to 74, with a mammogram every 2 years. The CDC repeats this advice for women at average risk (3). For women 75 and older, the Task Force says there is not enough evidence to judge the balance of benefits and harms, so the decision is made with a doctor (1).

Both standard digital mammograms and 3D mammograms (digital breast tomosynthesis) are effective (1). These recommendations are for average risk. If your mother, sister, or daughter had breast cancer, or you carry a known gene change, ask your doctor whether you should start earlier or have extra tests.

What Happens During a Mammogram

Before Your Appointment

The NCI suggests that you avoid scheduling the test right before or during your period, when breasts are most tender. On the day, skip deodorant, antiperspirant, and powders, and an over-the-counter pain reliever taken beforehand may ease discomfort (2). Wear a two-piece outfit so that you only need to undress from the waist up.

During the Test

Each breast is placed between two plates that are pressed together, and several pictures are taken from different angles. The NCI says the pressure can be painful for some people (2). Tell the technologist if it hurts too much, and ask her to explain each step.

After the Test

You will receive the radiologist’s report within about 2 weeks (2). The report also states how dense your breasts are. If you do not hear anything in that time, call the clinic and do not assume that no news is good news.

If You Are Called Back

Being called back for more pictures or an ultrasound is common. The NCI says that most people who are called back do not have breast cancer (2). The extra pictures help the radiologist look more closely at a spot that was not clear. Waiting for the answer is stressful, so bring a friend or family member to the follow-up visit if you can.

Dense Breasts

Breast density is how much of the breast is gland and connective tissue rather than fat. The NCI notes that mammography is more likely to miss cancer in women with dense breasts (2). The Task Force says there is not enough evidence on extra ultrasound or MRI for women with dense breasts and a normal mammogram (1). If your report says your breasts are dense, ask your doctor what it means.

Common Reasons Women Skip a Mammogram

A CDC review of studies of women in the United States found that the most common barriers were fear of the cost, fear of pain, and fear of bad news (4). Each one has a practical answer, and talking about them with your provider is a good start.

Cost. Most plans must cover screening mammograms every 1 to 2 years with no copay or deductible, and Medicare covers a yearly screening mammogram from age 40 (2). The CDC also offers free or low-cost mammograms through its National Breast and Cervical Cancer Early Detection Program (3).
Pain. The pressure is brief. Choose a time away from your period, take a pain reliever beforehand if your doctor agrees, and ask the technologist to go slowly.
Fear of the result. A mammogram can only find a problem earlier, when it is easier to treat. A callback does not mean cancer.
Lack of time. The appointment itself is short, and many clinics offer evening or weekend slots.

I was part of a team that studied this question in Estonia. In a survey of about 1,200 women aged 50 to 69, the women who did not have regular check-ups with a family doctor or gynecologist were more likely to miss screening, even when they had received an invitation (5). Regular check-ups, even without symptoms, may make it easier to take part in screening.

When to See a Doctor

A mammogram does not replace paying attention to your own breasts. Get to know how they normally look and feel, so you notice a change early. Contact a healthcare professional if you notice:

A new lump or thickening in the breast or armpit.
Changes in the size or shape of a breast.
Nipple discharge, especially if it is bloody or comes from one side only.
Dimpling, redness, or scaling of the skin or nipple.
Breast pain that is new, one-sided, or does not go away.

Most breast changes are not cancer, and breast pain alone is rarely a sign of it. For common causes of breast pain, see Breast Pain Explained. Do not wait for your next mammogram if you find a lump, because you need a visit now.

Conclusion

A screening mammogram every 2 years from age 40 to 74 is the main way to find breast cancer early. The test is quick, most callbacks are not cancer, and most insurance plans cover it at no cost. If cost, pain, or fear of the result is holding you back, talk to your doctor or the clinic first. Book your mammogram if you are due, and tell your doctor right away about any new lump.

Mammogram: What to Expect and Why It Matters

Quick Answer

Who Should Get a Mammogram and How Often