Reported Pain Following Mammography Screening. Arch Intern Med. The authors have no relevant financial interest in this article. Background Mammography screening for asymptomatic older women has been shown to be effective in reducing breast cancer mortality. Physicians and patients report pain as a major barrier for many women in the screening process; however, few studies report both the degree and type of pain women experience during the screening.
Methods Two hundred women 40 years and older were interviewed immediately following screening mammography. They were questioned about the pain they experienced, the difference between their experience and their expectations, and the most stressful part of the entire procedure. The highest level of pain reported resulted from the compression of the breasts 3. Ninety-six percent reported that the pain was "less than" or "about as expected. Conclusions The relatively low level of pain reported is useful information for both patients and practitioners.
Adherence to screening recommendations is more likely to occur when both parties are able to anticipate the most painful and stressful elements of mammography.
Age is the most important risk factor for breast cancer, with both morbidity and mortality increasing after 40 years. The largest increase occurs after 60 years of age. Breast cancer is one of the most preventable causes of cancer morbidity if it is detected early and treated appropriately. Mortality from breast cancer has decreased significantly between and and the decrease is partially attributed to earlier detection and better treatments.
The 3 major screening modalities for breast cancer are breast self-examination, clinical breast examination, and mammography. Studies support the value of screening mammography for women 50 years and older and of clinical breast examination for all adult women as effective means of detecting breast cancer.
Estimates of behaviors regarding breast cancer screening vary, and although there is evidence that more women are taking advantage of screening opportunities, 13 a general consensus exists that screening for breast cancer is underutilized.
Most studies report that women who are 60 years and older are less likely than younger women to have ever had screening mammography or to have been recently screened, 12 , 14 - 19 despite the fact that both the sensitivity and positive predictive value of mammography is greater for older women.
Explanations for why older women are less likely to be screened are complex; however, lack of physician recommendation appears to be particularly important. Based on the need to increase breast cancer screening among older women, a community education program was funded by the National Cancer Institute in The Program to Increase Screening Mammography PRISM , a 3-year project, was designed to recruit women 65 years and older who receive care in private primary care practices.
The 43 participating practices were randomized to receive either the educational program on breast cancer screening or a control program on skin cancer education. Before initiation of the program, focus groups of women aged 65 to 80 years were asked to determine their perceptions of barriers to mammography screening. In addition, a needs assessment of the physicians enrolled in the project was conducted.
Both women and physicians listed "pain during mammography" as a barrier to screening for many women. In addition, older women were more likely than younger women to mention pain as a barrier. Because both physicians and patients regard pain as one of the most important barriers, and one that needs to be addressed in any educational program, we decided to conduct a study to obtain detailed information on pain experienced during the mammography procedure, and to determine if pain is related to age.
Several studies have examined pain associated with mammography in different settings and at various times following mammography examinations.
Dullum et al 25 interviewed women 3 to days mean, 21 days following a screening mammography. Fifty-two percent of their sample reported experiencing moderate to extreme discomfort during the procedure on a scale where 0 indicates no pain and 4 extreme pain.
The earlier cancer is caught, the more treatment options that are available - and the better chance for recovery. Going into Beaumont to ha Do Mammograms Hurt? Answers to common questions about mammograms and pain can help better prepare women for this important screening. Beaumont Health. Keeping breasts in place for mammograms can cause bruising, though the compression isn't dangerous for any other reason. The innovation proposed by the company behind the new mammogram plates, Hologic, seems pretty intuitive, but it marks one of the first developments in mammogram technology in quite a while, and, it's hoped, might save more lives by encouraging women not to avoid their doctor's office like the plague.
Mammogram technology emerged in when Albert Salomon, a German scientist who would later survive a concentration camp in World War II, revealed he'd used radiography to scan breast tumors.
In the s, mammograms were performed by attaching long cones to X-ray machines and compressing the breast underneath, which is just as pleasant as it sounds. Today's mammogram machines are more sophisticated, but they operate under the same basic principle: compressing the breast between flat plates to get a good image of tissue inside. Unfortunately, that hurts.
The plate developed by Hologic aims to reduce discomfort by mimicking the natural curve of breast tissue. Their plate, which is called the SmartCurve, is meant to spread the force of the compression over breasts more comfortably. Communicating with your technologist will help them make minor adjustments to how they perform the monogram imaging. Request a slow, gradual compression, which can be less jarring than a sudden compression. Additionally, your technologist will give you more time to adjust and regain comfort before compressing the other breast.
The nervous anticipation of the mammogram imaging process can make your body tense, resulting in a less comfortable appointment. Keep your body relaxed by practicing calming techniques, like:. Before your doctor gradually compresses your breast between the imaging plates, take a deep inhale, then slowly exhale as you feel the compression. Comfortably hold your breath for a few seconds while the machine takes your image, which reduces nervousness and encourages a clearer image.
You can return to your typical daily routine after your appointment. A smaller percentage of women may experience bruising, especially women on blood thinners or those who are naturally prone to bruising.
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