The Squeeze, The Squish, The Press

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As I shared last week, I recently had an abnormal mammogram.

When the nurse called to tell me that I needed a diagnostic mammogram, I let out that sigh—the deep, tired, “of course” kind of sigh. I’ve been blessed with dense breasts, and I’ve been considering a breast reduction, so this felt… inevitable. It wasn’t my first abnormal mammogram. But it still landed with weight.

It’s not the mammogram itself that gets to me. The squishing? Fine—there’s plenty of tissue to work with. Being half-naked in a cold room? Childbirth cured me of modesty a long time ago.

What I mind is the cycle: going in already expecting an abnormal result, knowing it’ll mean a second appointment, rearranging my schedule, making calls, and then waiting—waiting for results that, statistically, will almost certainly be normal. It’s the emotional tax you pay even when everything turns out okay.

A woman stands in front of a mammography machine, preparing for a mammogram screening, highlighting the importance of regular breast health checkups.

When scientists talk about the “cost” of a diagnostic test, they’re not just referring to dollars. They mean side effects, false alarms, unnecessary procedures, and the emotional toll it takes on real people with real lives. Does the test generate too many false positives? Does it cause avoidable anxiety? Does it strain the system? Does it expose people to risks like radiation?

Breast cancer is the second most common cancer among women in the U.S. (skin cancer is first) and the second leading cause of cancer death (after lung cancer). Researchers have studied every early detection method—from self-exams to clinical exams to imaging—and mammograms remain the most effective screening tool we have.

But they’re far from perfect. Mammograms have about a 10% false positive rate from just one screening, and the likelihood increases the more mammograms you’ve had. They’re especially prone to false alarms in younger women and in those of us with dense breasts. To prevent one breast-cancer death, eighty-four women between ages 40–84 need to be screened.

And yet, despite the false positives, the callbacks, and the anxiety so many of us feel, regular mammograms are still recommended—usually beginning between ages 40 and 50, depending on the medical organization and your personal risk:

Mammogram screening guidelines:

	Age to start	Interval	Age to end
American Cancer Society	45 (can start at age 40)	45-54: annual             55+: every 1-2 years	When life expectancy is <10 years
American College of Obstetricians and Gynecologists	40	1-2 years	Age 75, then shared decision making
US Preventative Task Force	40	Every 2 years	74
European Commission Initiative on Breast Cancer	45	45-49: every 2-3 years 50-69: every 2 years 70-74: every 3 years	74

Different societies recommend different ages and intervals not because science is inconsistent, but because science is nuanced. Data evolves. Populations differ. And each person brings their own history, risk factors, and values. That’s why shared decision-making with your clinician matters so much.

A woman engages in a collaborative discussion with her doctor, emphasizing shared decision-making in healthcare.

A few added thoughts:

1. Radiation exposure from mammograms is minimal—roughly equivalent to the natural background radiation you’d experience over seven weeks. Research consistently shows the benefits outweigh the small risks.

2. Newer imaging technology helps reduce false positives. If you have access to 3D mammography (tomosynthesis), it’s particularly helpful for dense breasts. MRI is another option for high-risk patients, though insurance, access, and risk factors all play a role in what's practical.

3. Consistency matters. Many people prefer annual screenings simply because they’re easier to remember. Longer intervals—every 2–3 years—can be appropriate for some guidelines, but they also make it easier to lose track of time, which can delay diagnosis.

   
   

My follow-up testing—thankfully—was normal. And while I’m relieved, I’m also reminded that so many of us walk around carrying quiet, private worry while juggling work, families, appointments, and expectations. An abnormal test result, even one that turns out fine, is still a moment where life wobbles.

If you’re in that wobble right now—waiting for a call, sitting through a test, navigating uncertainty—I hope you know this: courage doesn’t always look like confidence. Sometimes it looks like showing up to your appointment anyway. Sometimes it looks like asking questions. Sometimes it looks like taking a deep breath and telling yourself, “I can do this.”

Screening isn’t easy, but it is powerful. It’s one way we choose ourselves—our health, our future, our ability to b

e present for the people and moments that matter.

And if your journey has a few extra sighs along the way? You’re in good company. I’m right there with you.

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