To explore the impact of radiolucent breast cushions on breast pain and image quality of full field digital mammography (FFDM) in screening subjects. The American College of Radiology (ACR) phantom and fifty-four women were enrolled in this study. Use of cushions reduced pain (p < 0.001). The imaging quality with cushions was inferior to those without cushions in phantom studies (p≦0.01), on CC views (p=0.02) and on positioning (p<0.05). Although use of cushions reduces pain during FFDM, these cushions potentially decreased imaging quality and might hinder breast positioning. More research needs to be done prior to the routine use of these cushions in clinical practice.