Afraid of the upcoming mammogram. Do not want to do it.

I am new to this board.

I am 38 years old. Last year, I started experiencing pain in my breast. My GP sent me for a diagnostic mammogram, since I was approaching 40 and would need it soon anyway. I wasn't worried, did not think about cancer, did not do any research prior to going in. I was told I had very dense breast tissue and an ultrasound was done as well. Everything came back clear.

I continued having breast pain that year, off and on. Last week I felt that the nodes under my arms were enlarged and tender, more on the right side, slightly on the left side. I wasn't too worried and thought my body was fighting some sort of infection. Two days later, the nodes went back to normal, but I found a lump in my right breast.

I am now scheduled for a diagnostic mammogram once again and an ultrasound.

During this most recent visit to my gp, I was very anxious and didn't think to ask any coherent questions. I came home and spent the entire day sobbing. I am now finally feeling capable of thinking about this and actually doing some research. I was glad to find this board.

I have a question that will probably sound unreasonable, but would love some opinions from more experienced members.

In reading about mammograms and ultrasounds, I noticed that mammograms are not very reliable when it comes to dense breast tissue. They can show some calcification, but can't distinguish between a cyst and a tumor. I see that they are a decent screening method when a person doesn't have any symptoms. But I already have the lump and know where it is. It appears that after doing the mammogram, it is inevitable that I will be doing the ultrasound again due to extremely dense breast tissue and possibly the biopsy. My experience last year was that the mammogram wasn't too useful in my case and the doctor relied mostly on my ultrasound.

I am sure this sounds very childish/unreasonable but I am finding the thought of the second diagnostic mammogram that I am about to have in two days terrifying. I am uncomfortable going through with the exam that in my case, due to dense tissue, is not very useful. It will be painful, since I have a very painful lump and the entire right side of my breast is very tender. I can't imagine that part being smushed with a mammogram to get an image that won't show much. I am also worried what the pressure of the mammogram will do to the tumor, especially if it is cancerous. Finally, I read that in many countries in Europe, ultrasound is the primary diagnostic tool for women who are 35-39 years of age, with dense breast tissue. Mammogram is not recommended at all. If this is a cyst and if I will be dealing with this in the future, I can't have a diagnostic mammogram for every single lump in the future. I know the radiation is not high, but it is cumulative.

After reading it all, I now don't want to do the mammogram and would like to just do the ultrasound and biopsy, if needed. I would be open to an MRI, but I know the insurance probably wouldn't cover it. Anyway, I wanted to ask, is it crazy to ask to skip the mammogram and just do the ultrasound? Would any doctor allow this, and would the imaging place be ok with it? Has anyone done/requested this? I would love to get some opinions, even if it is to tell me that I am completely irrational. It is quite possible that due to intense fear and anxiety, I am randomly fixating on something that is not important. I am just very stressed out over this.