Age 45 f, 30-year smoker, mod. Overweight with occasional chest pain. Chest xray the 1st test a doc should order? Haven't been to a doc/gyn in 20 y.

Too simplistic. You have several things that need to be looked into. There is no first test. The dr needs to get a detailed history and perform a thorough physical. You need a mammogram, pap smear, chest x-ray, ecg, and a some blood work. Issues to be looked into includ diabetes, lung diseases, heart diseases, breast ca, and cervical ca and more. You should see a doctor and get checked out.