Do you feel anxious before a mammography session? If yes, you are not alone.

Although Mammography is the Gold Standard^[1]  test for routine screening, which has reduced breast cancer deaths worldwide by 30% to 50%^[2] due to early diagnosis, some women feel anxious about undergoing Mammography. Exactly like some regular fliers get anxious before each flight or experienced public speakers feel it before every speech.

This stress could be due to either it being your first mammogram, your fear of discovering cancer, or your past uncomfortable experience.

Whatever could be your reason, it’s important to remember that mammograms save lives, and there are ways to manage your anxiety and make the experience more comfortable.

Here are seven tips to help you relax before your next mammogram: 

1. Learn the latest about mammograms.
   It’s much more comfortable getting a mammogram today- thanks to progress in technology.
   • Less than 10 seconds is all it takes for the latest 3D mammography machines to capture a high-quality mammogram image. This minimizes the time duration for which the breast tissue is compressed. Check if there is a 3D mammography center near you.
   • A comfort-improving feature called Curved Compression Surface with its cushions minimizes the pressure and discomfort during mammography by mirroring the shape of the breast for more uniform compression.

2. Know what to expect.
   Mammography-related anxiety can be reduced by knowing what to anticipate.
   • If you are a first-timer, find out from your radiologist what to expect during the process, how long it will last, what to wear, etc. Feel free to ask about any discomfort you might encounter during the procedure so you know in advance about it, making it easier to manage.
   • Some women who previously used older machines sometimes complained about their discomfort or pain. Beware: Memories of your previous mammography might influence your next experience more than the actual experience.^[3] Hence do not expect the old experience to repeat itself.
   • Expect compression during mammography and know its benefits: In mammography, breast compression is a critical factor^[4] to produce clearer images with minimum radiation doses.^[5] In 38% of poor mammography images, inadequate compression played a role as reported by a study and US FDA.^[6],^[7]Compression also helps avoid your accidental movement or breathing motions interfering with the scan, which may otherwise produce blurry or unclear mammograms.

3. Schedule your mammogram at the right time.
   Avoid mammograms from a week before and during your periods.^[8] The best time to get a mammogram is one to two days after your period when breasts are less sensitive, and less dense- especially in pre-menopausal women.^[9] Additionally, try to schedule it when you are not rushed or pressed for time.
4. Bring a support person if needed.
   Mammography is a short outpatient imaging test that doesn’t require admission or prescription. It neither involves any cuts nor needle pricks. However, if you still feel nervous, consider bringing a friend or family member to the appointment. Having someone there to support you can help ease your anxiety and make the experience more comfortable.
5. Know what to wear.
   • Wear comfortable, loose-fitting clothing for your mammogram appointment. Avoid wearing jewelry or clothing with metal buttons, zippers, or snaps, as these can interfere with the mammogram.
   • Certain commonly found elements or compounds of zinc, magnesium^[10] & aluminum^[11] in your deodorant, antiperspirant, talc or some lotions can appear in your mammogram as white spots resembling specs of cancer tumors. So, please avoid them.
   • If you’re particularly sensitive or anxious about the mammogram, talk to your radiologist about using a skin-numbing cream before the procedure.^[12][13] This can help reduce any discomfort you may feel during the test.

6. Practice relaxation techniques
   Before your mammogram, try practicing relaxation techniques such as deep breathing, meditation, or visualization.^[14] These techniques can help calm your nerves and ease any anxiety you may be feeling.

7. Focus on the Benefits.
   Focusing on the benefits of mammography can help you overcome your anxiety and make it easier to go through this life-saving test every year.
   • Remember that mammography is an important tool for detecting breast cancer early when it is most treatable because no one can prevent breast cancer.
   • The other perceived alternatives such as Self Breast Examination, Ultrasound, etc., are not recommended by most medical organizations across the world for early detection of breast cancer.
   • No one is immune to breast cancer. About 50% of breast cancers develop in women with no identifiable risks other than gender and age.^[15] Some women are at higher risk than this due to family history, breast density, genetics, personal history of breast disease, obesity, smoking, etc.
   • Early diagnosis dramatically improves the chances of complete cure and disease-free survival with 93% or higher survival rates in the first five years.^[16]
   • Annual screening mammograms can substantially reduce your stress & medical expenses: Just like car insurance premiums, spending a small amount on mammography every year may help you save 30% to over 100% of the treatment costs of breast cancer compared to the women who are diagnosed with advanced-stage breast cancers⁷. You may avoid the need for chemotherapy, removing the entire breasts, etc., with early detection with mammography.

However, mammograms do not provide immunity against breast cancer. If your first mammogram is clear, it neither predicts nor assures that you will be free of breast cancer in the future.

Hence if you are eligible for breast screening either by age (40 years and above) or due to high-risk factors such as family history (in which case even if you are younger than 40 years), subscribe to an Annual Screening Mammography Plan right away– A simple ritual that can save your life!

1. https://www.webmd.com/breast-cancer/features/mammography-still-gold-standard-for-breast-cancer
2. Feig S. Comparison of Costs and Benefits of Breast Cancer Screening with Mammography, Ultrasonography, and MRI. Obstetrics and Gynecology Clinics of North America. 2011;38(1):179-196. doi:10.1016/j.ogc.2011.02.009
3. Kornguth PJ, Keefe FJ, Conaway MR. Pain during mammography: characteristics and relationship to demographic and medical variables. Pain. 1996;66(2):187-194. doi:10.1016/0304-3959(96)03057-6
4. https://www.fda.gov/radiation-emitting-products/mqsa-insights/compression-another-critical-factor-image-quality#:~:text=Compression%20is%20necessary%20to%20separate,needed%20to%20perform%20the%20mammogram. Accessed on 4 June 2022
5. Holland K, Sechopoulos I, Mann RM, den Heeten GJ, van Gils CH, Karssemeijer N. Influence of breast compression pressure on the performance of population-based mammography screening. Breast Cancer Research. 2017;19(1). doi:10.1186/s13058-017-0917-3
6. van Lier MGJTB, de Groot JE, Muller S, den Heeten GJ, Schilling KJ. Pressure-based Compression Guidance of the Breast in Digital Breast Tomosynthesis Using Flexible Paddles Compared to Conventional Compression. Journal of Breast Imaging. 2020;2(6):541-551. doi:10.1093/jbi/wbaa070
7. https://www.fda.gov/radiation-emitting-products/mqsa-insights/compression-another-critical-factor-image-quality Accessed on 4 June 2022
8. https://my.clevelandclinic.org/health/diagnostics/4877-mammogram Accessed on 4 June 2022.
9. Miglioretti DL, Walker R, Weaver DL, et al. Accuracy of Screening Mammography Varies by Week of Menstrual Cycle. Radiology. 2011;258(2):372-379. doi:10.1148/radiol.10100974
10. Chaloeykitti, L., Muttarak, M., & Ng, K. H. (2006). Artifacts in mammography: ways to identify and overcome them. Singapore medical journal, 47(7), 634.
11. Mesurolle B, Ceccarelli J, Karp I, Sun S, El-Khoury M. Effects of antiperspirant aluminum percent composition and mode of application on mock microcalcifications in mammography. European Journal of Radiology. 2014;83(2):279-282. doi: https://doi.org/10.1016/j.ejrad.2013.10.015
12. Lambertz CK, Johnson CJ, Montgomery PG, Maxwell JR. Premedication to Reduce Discomfort during Screening Mammography. Radiology. 2008;248(3):765-772. doi: https://doi.org/10.1148/radiol.2482071490
13. Lambertz C, Montgomery P, Fry S, Johnson C, Maxwell J. Toxicity of topical lidocaine applied to the breasts to reduce discomfort during screening mammography. Journal of Anaesthesiology Clinical Pharmacology. 2012;28(2):200. doi: https://doi.org/10.4103/0970-9185.94859
14. Vidya R Pai, MD, FACR, Murray Rebner, MD, FACR, FSBI, How to Minimize Patient Anxiety From Screening Mammography, Journal of Breast Imaging, Volume 3, Issue 5, September/October 2021, Pages 603–606, https://doi.org/10.1093/jbi/wbab057
15. https://www.who.int/news-room/fact-sheets/detail/breast-cancer Accessed 16 Sep 2022
16. https://www.carolmilgardbreastcenter.org/for-patients/facts-myths/early-detection-is-key/ Accessed on 6 June 2022.