But there may be situations that make you second-guess your annual screening. “Don’t skip your mammogram. It could save your life,” says breast imaging radiologist Toma Omofoye, M.D. “With the right tools and our expertise, we can personalize our screening approach to your individual needs.”
Here, she shares seven situations when you might think it’s OK to skip a mammogram – but shouldn’t.
1. Don’t skip a mammogram if you have breast implants.
If you have breast implants, you may be hesitant to get a mammogram due to fear of damaging the implant. “We take special care not to damage implants during mammograms, so the risk here is really low,” Omofoye says. She adds that women with breast implants should be more inclined to get an annual mammogram. That’s because beyond screening for breast cancer, in some cases, mammograms can help check that an implant is still intact.
“Sometimes with silicone implants, you may not know they’ve ruptured. Mammograms are one way to tell that’s not too invasive,” Omofoye says.
Since implants can obscure breast tissue during imaging, your care team may reposition the implants with their hands to temporarily to get a better look. They may also suggest additional imaging techniques, like an MRI or ultrasound, that don’t require putting pressure on the breast.
“Before your appointment, let us know about if you have breast implants so we can plan ahead and cater to your specific needs,” Omofoye says.
It’s also important to share your breast implant history with your care team because certain types of breast implants also increase your risk of breast-implant associated anaplastic large cell lymphoma.
2. Don’t postpone a mammogram while you’re pregnant or breastfeeding.
“In general, being pregnant or breastfeeding reduces your risk of breast cancer, but it’s not a guarantee,” Omofoye says.
Sometimes changes to your breasts during pregnancy or breastfeeding can mimic breast cancer symptoms. If you notice a lump, unusual discharge, rash, skin discoloration or nipple changes, you should not ignore these symptoms, Omofoye says. If you experience these for two weeks or longer, tell your doctor.
If you have a mammogram scheduled while you’re breastfeeding, your care team may ask you to pump right before your exam to express as much breast milk as possible. “This can make the procedure more comfortable and help us get a clearer image,” Omofoye says.
You may also be eligible for an ultrasound or other imaging that could reduce potential discomfort.
Depending on how long you plan to breastfeed, you may opt to delay a mammogram for a month or two. But, Omofoye says, it’s important to maintain your regular screenings, especially if you plan to breastfeed for a year or more.
3. You still need an annual mammogram after breast cancer surgery.
Cancer can occur in any part of the breast tissue and can be found in nearby lymph nodes, Omofoye says.
Even though all breast tissue is removed during a mastectomy, you’ll still need to work with your care team to determine which preventive screenings are right for you.
If you’ve had a lumpectomy, you should still be getting mammograms, since you’ll still have some breast tissue.
Especially if you’ve only had one breast affected, you should be screening the other breast to monitor any abnormalities.
4. Mammograms are still needed during gender transition.
Individuals going through gender transition may be at increased risk of hormone-driven breast cancer because of hormone therapies. “When you adopt hormones, you adopt the risk that comes with them,” Omofoye adds.
No matter your gender identity or transition status, it’s important to keep up with preventive health care. For example, if your assigned gender is female and you’re transitioning to male, you may still need breast cancer screening. Similarly, biological males transitioning to female may need mammograms to keep an eye on their breast health.
Part of that means partnering with a care team you trust to make sure you’re getting the right screenings for you. “Our job is to be a part of your team to help you achieve your health goals,” Omofoye says.
5. Don’t skip your mammogram because you’ve had a history of normal results.
“Even if you’ve always had normal mammograms, you should still get them regularly to be sure we’re not missing anything,” Omofoye says. Breast tissue changes over time, and cancer can develop at any time.
Studies show cancer found between yearly mammograms tends to be smaller and responds better to treatment than cancers found later.
6. It’s safe to get a mammogram during the COVID-19 pandemic.
Fear of contracting COVID-19 shouldn’t keep you from getting your annual breast screening. “The longer you wait in between mammograms, the more opportunity for something potentially serious to grow, which could make treatment more challenging,” Omofoye says.
But it’s important to time your mammogram carefully because the COVID-19 vaccines can cause lymph nodes to swell, which could lead to an abnormal mammogram result. If you haven’t received your COVID-19 vaccine or booster yet, schedule your breast screening first. If you’ve had a recent vaccine, let your care team know so they can watch for any potential vaccine-related changes.
7. Mammograms are needed even as you age.
While women at average risk of breast cancer should start getting mammograms at age 40, there’s no age recommendation for stopping them. “People are living longer, and living well longer, so there’s really no reason to stop your regular health screenings due to age,” Omofoye says.
She also points out that it’s important to build a relationship with your care team and discuss your health goals. When breast cancer is diagnosed early, most patients need much less invasive treatment, so no matter your age, getting regular screenings can reduce your chances of having to go through grueling treatment.
“Our goal is to help you achieve the greatest health possible, no matter where you are in life,” Omofoye says.