Is a mammogram possible for women with very small breasts?

Very small breasts and the mammogram: If you’re a woman who’s approaching the age at which it would be a wise idea to start getting a mammogram, and  —  if you just happen to have very small breasts, you might be wondering if it’s even possible to have this procedure done.

After all, perhaps you’ve seen photos or videos of the mammogram procedure, in which a woman’s breast is literally set atop a platform while she stands, and then the equipment is clamped down upon her breast, compressing it, almost like a vice.

How can this be possible if a woman’s breasts are so small that it’d seem that there’s not enough tissue to set atop the platform and then compress?

I had very small breasts, so I know what it’s like to have a mammogram.

Ultimately I chose to have an elective, prophylactic double mastectomy after learning my sister had breast cancer, but up to that point, I’d been very experienced with undergoing mammograms.

It’s not the easiest thing in the world for the technician to position very small breasts for an accurate reading by the machine.

My size was what I called “sub-A,” meaning, I don’t quite fill an A cup.

Thus, there is nothing for the technician to easily grab onto and place atop the platform. However, it can be done.

“Mammograms are meant for women and men of all breast sizes,” says Anjali Malik, MD, a board certified diagnostic radiologist with Washington Radiology in Washington, DC. She interprets mammograms, breast MRIs and ultrasounds, and performs biopsies.

“That’s right, I said men,” continues Dr. Malik. “While the average man has predominantly fatty breast tissue with more pectoralis musculature, they are still eligible for and able to undergo mammography.”

Man undergoing a mammogram.

The procedure will take a little longer than it will for a patient who has larger breasts that can be taken in the hand of the technician and literally placed, like a water balloon, on top of the platform.

More than once, the technician has had to make several adjustments for each of my breasts before finally taking the image.

If you have a very small chest, don’t let that stop you from getting a mammogram. Don’t assume that it can’t be done or that it’s not worth it.

I’ll be honest about something: It’s not comfortable. The impression I got from the technician was that the compression was more pronounced because of the size of my chest.

However, the compression will not injure you or increase the risk of cancer.

It may hurt quite a bit, but it’s harmless and won’t damage your body in any way.

“A new mammogram stabilization system from Hologic called the SmartCurveTM is designed to have a curve simulating that of the breast, and offers a more comfortable experience for some women and breast shapes,” says Dr. Malik.

“For women who have physical limitations due to chest, breast or shoulder surgeries; congenital deformities of the rib cage called pectus excavatum or pectus carinatum; or for other physical limitations or some patients who are wheelchair-bound — positioning of the mammograms might be technically challenging, and the images may be suboptimal.

“For these women, a combination of mammogram and ultrasound may be offered for complete annual screening surveillance.”

Dr. Malik is a frequent public speaker and advocate for breast health awareness. She has lectured on the latest advances in breast cancer screening including 3D Mammography™. Follow her on Instagram: @AnjaliMalikMD
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.