Too busy.

Pain avoidance.

Believing that no news is good news.

Dr. James Coley, a hematologist/medical oncologist with Novant Health Cancer Institute - New Hanover, has heard all the reasons women give for putting off a mammogram, an X-ray of the breast used to screen for breast cancer. He knows they understand its importance. And he’s sympathetic, never dismissing anyone’s fear.

But after he tells you he understands where you’re coming from, he’ll probably come back — gently — with a rational reason why you really ought to prioritize your annual mammogram. More than 320,000 women in the U.S. will be diagnosed with invasive breast cancer this year, and a mammogram can detect cancer even before there are symptoms, like a lump you can feel.

Here are seven common reasons that Coley says you might be skipping your mammogram, and why he encourages you to reconsider.

This is the reason Coley hears most often. And he understands. “Doctors don’t dismiss the fear,” he said. “We acknowledge it. We hear it, we get it, but we also want patients to understand that early detection is the key to making a diagnosis, if there is one, less scary.”

Chances are that you’ll receive good news following a screening mammogram. Of women who are called back for additional imaging or diagnostics following a screening mammogram, fewer than 1 in 10 are found to have cancer.

Another reason that it makes sense not to put off a mammogram? Because if you need surgery, it will be less invasive and less extensive if the cancer is caught early. Your chances of surviving increase with early detection, too. The five-year survival rate for breast cancer detected at an early, localized stage is more than 99%.

2. “I’m afraid a mammogram will hurt.”

Mammograms involve compression of the breast tissue, which can be intimidating. But your mammogram technologist’s job is to make the process as quick and painless as possible.

“Techs are very well-trained,” Coley said. “Most do only mammograms and they’re able to do them as gently as possible. And quickly. Most women describe it as just a little bit of pressure. But it isn’t sustained pressure. It’s over quickly. If you have sensitive breasts or are nervous, let the tech know.”

3. “I don’t have a history of breast cancer in my family.”

Don’t let this give you a false sense of security. “There’s no group of people excluded from breast cancer,” Coley said. “You can get it with or without a family history of the disease. Close to 1 in 8 women will be diagnosed in her lifetime, and that statistic includes women who have no family history of the disease.”

4. “My grandma/mom had breast cancer, and I don’t want to find out I have it, too.”

If only not knowing meant not having cancer. It doesn’t. But Coley is sympathetic to the impulse to stay in the dark. “I’ve had patients who say their mother or grandmother did everything they were supposed to do and still, they got breast cancer,” Coley said. “As a result, they’re reluctant to get a mammogram.”

He tells patients: “The standard of care for breast cancer treatment has, thankfully, dramatically advanced in the past decade. When caught early, the outcome can be very different from that of your loved one who was treated 10, 15 or more years ago. Survival rates have increased dramatically over the last two decades.”

5. “I’m too young to get breast cancer.”

Novant Health recommends a yearly screening mammogram for women of average breast cancer risk starting at age 40. But, Coley cautions that doesn’t mean that women younger than 40 are immune. “We recommend discussing with your primary care provider or OB-GYN any breast changes, regardless of your age. And you shouldn’t delay. Unfortunately, we often see breast cancer in women younger than 40, so it’s important to have any breast change evaluated by someone on your care team to determine if further diagnostic imaging is necessary.”

6. “I don’t want the radiation exposure from a mammogram.”

This excuse has been cropping up more in recent years, and Coley believes social media is partly to blame. But it’s hard to combat messages people are seeing repeatedly. Every time it pops up, that fear is reinforced. Coley wants women to know: “There is no evidence that the very low dose of radiation delivered during a mammogram is associated with breast cancer.” The American Cancer Society emphasizes that the benefits of mammograms outweigh any potential harm from radiation exposure.

7. “My schedule is too busy for a mammogram.”

Coley knows that women are likely to prioritize work and family caregiving over taking care of themselves. If that describes you, then consider a mammogram your gift to the people at home and at work who rely on you.

And it’s worth noting that mammogram appointments are typically very efficient. You’re likely to be in and out in less than 30 minutes. “You could spend more time looking for a parking spot at a breast imaging center than getting a mammogram,” Coley said.

And there’s a lot of choice. Novant Health works hard to make it quick and easy to get a mammogram. Some facilities even have weekend hours, and Novant Health’s mobile mammography buses bring mammogram services to locations within the community.