What is a mammogram? At what age, does it hurt, how to prepare, and subsidised screening or private in Hong Kong
A mammogram takes X-ray images of the breast; during the test a plate presses the breast flat; this can hurt or feel uncomfortable, and it is usually over in a few seconds (Department of Health breast cancer screening website, August 2026). When to start and how often are recommended by the Cancer Expert Working Group according to breast cancer risk level; individual cases are decided by the doctor.
What is a mammogram?
A mammogram is an X-ray picture of the breast and one of the more widely used breast cancer screening tests; the Department of Health breast cancer screening website says research supports its ability to find early tumours that are hard to feel by hand (August 2026).
Screening usually uses two-dimensional (2D) imaging, which most countries treat as the standard; the Department of Health website says there is not yet enough evidence that three-dimensional (3D) imaging used for population screening reduces breast cancer deaths, although women with denser breast tissue may benefit and can talk it over with a doctor, and women with dense breasts can also have an ultrasound added to help (Department of Health breast cancer screening website, August 2026).
No screening is completely accurate: it may raise a false alarm (false positive) or miss something (false negative), and it may find changes that would never have caused a problem, leading to unnecessary treatment; the Department of Health website advises women to meet a doctor before screening to understand the benefits and risks (Department of Health breast cancer screening website, August 2026).
At what age does mammogram screening start?
The Cancer Expert Working Group on Cancer Prevention and Screening makes recommendations by breast cancer risk level, shown in the table; individual cases are decided by the treating doctor. For other screening recommendations for carriers of gene mutations see BRCA mutation carriers screening.
| Risk level | Working Group recommendation for mammogram screening |
|---|---|
| High risk: for example a BRCA1 or BRCA2 disease-causing mutation confirmed by genetic testing, a strong family history of breast or ovarian cancer, or chest radiotherapy between the ages of 10 and 30 | Ask a doctor first; one mammogram a year from age 35, or starting 10 years before the age at which the youngest relative was diagnosed, but no earlier than 30 |
| Moderate risk: one first-degree female relative diagnosed with breast cancer at or before 50, or two first-degree female relatives diagnosed after 50 | One mammogram every two years; before screening, ask a doctor about the benefits and risks |
| Women aged 44 to 69 whose risk is higher because of certain combinations of personal risk factors | First assess with the breast cancer risk assessment tool; where risk is raised, one mammogram every two years is recommended; before screening, ask a doctor about the benefits and risks |
Where can I have a mammogram? Subsidised screening, public or private?
The Government provides subsidised screening for women at moderate risk or whose risk is raised by personalised risk factors: District Health Centres and DHC Expresses provide prevention-based, personalised primary healthcare services for eligible women, and those with women's health risks are arranged to attend a Women Wellness Satellite (樂妍站), whose services include breast cancer screening; existing members of Department of Health Elderly Health Centres can ask their own centre (Department of Health breast cancer screening website, accessed October 2026).
Conditions for the Phase 2 Breast Cancer Screening Pilot Programme include: aged 35 to 74 (those with a family history may start ten years before the youngest age at diagnosis in the family, but not before 30), holding a Hong Kong Identity Card or Certificate of Exemption, enrolled in eHealth, at high risk of breast cancer, without breast cancer symptoms or history, and no mammogram screening in the past year (unless due for screening as advised by a doctor) (Department of Health breast cancer screening website, accessed October 2026); for the genes the programme lists see BRCA mutation carriers screening.
A radiographer may not perform diagnostic imaging without a referral from a registered medical practitioner, dentist, Chinese medicine practitioner, chiropractor or similar, except in an emergency, and referrals from dentists, Chinese medicine practitioners outside the Chinese Medicine Hospital of Hong Kong and chiropractors are limited to specified plain X-ray tests (Radiographers Board Code of Practice, December 2025). For public and private mammogram fees see mammogram fees.
Does a mammogram hurt? What should I note before the test?
You take off your top and a plate presses the breast flat while pictures are taken from a few angles; the pressing may hurt or feel uncomfortable but is usually over in a few seconds, and flattening the breast gives a clearer picture and a more accurate reading (Department of Health breast cancer screening website, August 2026); the website also says that overall the test is safe and the radiation received is very small (accessed October 2026).
The Union Medical Imaging and Health Check Centre (operated by Union Hospital) states: tell staff before the test if you may be or are pregnant; do not apply antiperspirant, talcum powder or skin cream, or wear dressings or plasters, on the breasts and underarms; tell the radiographer first if you have breast implants; bring previous mammogram and ultrasound images and reports; undress to the waist for the test, and the compression may cause discomfort or slight pain for about ten to twenty seconds; each breast is usually imaged from two angles, and the whole test takes about 20 to 30 minutes (accessed October 2026). Requirements differ between hospitals; follow the instructions of the hospital where you book.
Called back or an abnormal result: what next, and who decides?
Being asked to have an extra mammogram or ultrasound after screening is not uncommon; it may be because the first images were unclear (for example because of dense breast tissue) or because tissue needs further assessment, and it does not necessarily mean breast cancer (Department of Health breast cancer screening website, accessed October 2026). For what happens after an abnormal result see abnormal mammogram next steps.
Whether to be screened, when to start and how often are decided by the doctor according to individual risk; the report is interpreted by the doctor, and individual cases are decided by the treating doctor. For choosing a doctor see how to choose a breast cancer doctor.
Frequently asked questions
At what age should mammograms start?
The Cancer Expert Working Group makes separate recommendations by risk: high risk, one mammogram a year from 35, or starting 10 years before the youngest relative's age at diagnosis, but no earlier than 30; moderate risk, every two years; women aged 44 to 69 whose risk is higher because of personal risk factors, every two years; in the last two groups, ask a doctor about the benefits and risks before screening (Department of Health breast cancer screening website, accessed October 2026). Individual cases are decided by the treating doctor.
Does a mammogram hurt?
Pressing the breast flat can hurt or feel uncomfortable, and it is usually over in a few seconds (Department of Health breast cancer screening website, August 2026); the Union Medical Imaging and Health Check Centre states that compression lasts about ten to twenty seconds (accessed October 2026).
Can I use antiperspirant before a mammogram?
The Union Medical Imaging and Health Check Centre states not to apply antiperspirant, talcum powder or skin cream, or wear dressings or plasters, on the breasts and underarms, so that image clarity is not affected (accessed October 2026); requirements differ, so follow the instructions of the hospital where you book.
I was called back after a mammogram. Does that mean breast cancer?
Being asked to have an extra mammogram or ultrasound after screening is not uncommon; it may be because the first images were unclear or need further assessment, and it does not necessarily mean breast cancer (Department of Health breast cancer screening website, accessed October 2026); the report is interpreted by the doctor.