What Nobody Tells You About Mammograms

Today, October 1, marks the first day of Breast Cancer Awareness month – and a particularly timely topic for me, since I reached the age where a first mammogram is recommended. (The American Cancer Society says an average-risk woman like myself should start yearly mammograms at age 40.) Because of this, I’m taking a moment to write about my experience with my first mammogram – and if you are age 40, to go get one done, if you haven’t already.  Going into it, there are a few things I wish I had known and that I’m sharing with you now.

The First Mammogram Is Scary

There’s no way around it; getting that first mammogram is scary. No matter how gentle the staff is, or what type of machine they use, you’re still staring down a behemoth of a machine. You’re facing the fact that you’re 40, and that by all accounts, you’re middle-aged. It’s not a great feeling, and it’s a harsh reminder of your own mortality. Add in the fact that you’re wearing a scratchy wrap-front clinic top, and before you’ve even gotten the mammogram, you’re already pretty uncomfortable.

Mammograms Can Hurt

Your doctor isn’t going to tell you this, but I will: mammograms hurt. It’s a brief amount of pain, but it’s still pain as your breasts are squished between a couple of radiology plates. You have to stand as still as possible and breathe, and it’s not easy. I don’t know if the pain is less if you have larger breasts, but my small ones were definitely squeezed uncomfortably.

You’ll Feel Manhandled

Again, this may be specific to small-breasted women, but getting into position for a clear mammogram is no easy feat. At my first mammogram, the radiologist had to shift and re-position me so that she could get a clear image.

You’ll Probably Get Called Back

Getting called back for a second mammogram is fairly common, and I feel like this wasn’t emphasized enough. Needing a second mammogram does not mean you have cancer. In my case, and in a lot of cases, it can be normal calcifications that occur as you age. Or it can be because you have dense breast tissue, and the radiologist needs another view. But fewer than 1 in 10 women who get called back for a second mammogram have cancer, so if you do get called back, keep calm and carry on as usual.

Know Your Insurance Plan

Under the Affordable Care Act, your health insurance plan must pay for your screening mammogram. However, if you have to go back for a second mammogram, make sure you know how it’s covered. For example, you may have to pay out of pocket until you hit your deductible, so shop around for a center that won’t sock it to you. Or, if you’re lucky, your health insurance will cover a diagnostic mammogram if you go to an in-network provider.

Don’t Go to Solis Mammography

My ob/gyn referred me to Solis Mammography, a chain of mammogram centers in Texas, Ohio, North Carolina, Arizona, and Pennsylvania. I wish she hadn’t. My first mammogram there was fine, although I ended up not having my follow-up there. Why?

Solis is not an in-network provider for my health insurance. When I arrived for my follow-up, I was informed that my out-of-pocket cost was $916 – suspiciously close to my deductible with an “insurance discount.” No one had called me to inform me of this, so I walked out. While the center director reached out later, the damage was done – I was not going back, and I was not going under private pay for $500, either (something the woman at the billing desk didn’t provide the option of doing at all).

Oh, and it gets better: I just received a bill from Solis for my first mammogram, with the notation that my insurance was “not in effect” at the time of service. This is a deceptive practice if they can’t inform the patient ahead of time or at the time of service, and if they’re removing my insurance information to try to get me to pay more.

Still – don’t hesitate to get your first mammogram! If you haven’t yet hit 40, there are still things you can do to detect cancer and assess your risk. If you’ve taken a 23andMe test, you can run the results through Promethese to find out if you have a BRCA gene mutation. You can do regular self-exams. Remember, breast cancer is the second most common cancer in women, right after skin cancer, and early detection is critical for treatment.