Mammograms may not need to be so painful

Mammograms may not need that painful ‘squish’. Should I be relieved or appalled? | Mona Gable | Opinion | The Guardian

Many women don’t know all this, since public health and breast cancer awareness campaigns emphasize early detection over all the subtleties.

So women continue to support a mammography economy that promises them a false sense of security.

Relatedly, many studies, including a 2012 study in the New England Journal of Medicine, show that women who had mammography screening were just as likely to die as women who didn’t have mammograms

“In other words, mammograms increased diagnoses and surgeries, but didn’t save lives,” Dr David H Newman wrote in the New York Times.

Still, millions of women dutifully endure the squeezing and the anxiety every year. We do it because we’ve been assured that it detects breast cancer early, which it does, though with a lot of caveats, like not being able to distinguish between early-stage cancers that are ultimately deadly and those that won’t grow, leading to overdiagnosis and treatment – more needless pain for more women.

They would have looked more closely at the data – the high rates of false-positives that require women to get a second mammogram and then wait for those results while worrying, do I have cancer or don’t I? This has happened to me twice.

Maybe a technology that effectively hasn’t changed since the 1960’s doesn’t give the best results.

I’m thrilled that a researcher decided to look into this aspect of mammograms, and I hope his findings lead to gentler mammograms in the future.

But I have to ask: no one thought of this before?

Even Dustler acknowledges that researchers have shown little interest in the relationship between pressure, pain and image quality in this widespread screening tool.

Still, why did it take so long? If it were men having this medieval procedure annually, the medical profession would have taken the pain it causes far more seriously.

data from 20 to 150 women to measure how pressure is distributed on the breast during mammograms. He found that when the compression was reduced by half, it had little effect on how the pressure was dispersed over the central areas of the breast, which Dustler says are the most important diagnostically.

now new research from Lund University in Sweden reveals that all that squeezing and pain women go through is probably unnecessary, as the images that result don’t inevitably lead to a better diagnosis.

Like most women, I dread going for my mammogram. Just the thought of having my breasts pinned between two hard plates, one hand gripping a bar overhead while a technician tries to shove them into position, is enough to make me sweat. Talk about painful.

I had posted about unnecessarily painful mammograms previously: Mammograms: Technology and Pain

Of course, there is a clear gender bias in this technology. If this were a check for testicular cancer they would have found a way to make it less painful long ago. It saddens and disillusions me that no one ever considered the woman’s pain as important enough to minimize it.

At almost 60, I have never had a mammogram.

First, because I always believed they would find benign growths that would never become dangerous and second, because they used such a barbaric and primitive mechanism. I felt it was humiliating and unnecessary.

After all these years, it turns out that medical science is coming around to my view.

 

 

 

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9 thoughts on “Mammograms may not need to be so painful

  1. Laura P. Schulman, MD, MA

    After my GYN put her foot down and refused to refill my estradiol rx unless I had a mammogram, I went and got one. How bad could it be, right?

    I have tiny little breasts, full of lumps and bumps and scar tissue from fibrocystic disease. First there was the problem of getting them into the clamp at all, because they are small and stuck to my chest wall. Then it seemed like the only way to get them to stay in position was to clamp them harder. Did I mention that fibrocystic disease is painful? Then, predictably, the radiologist couldn’t make heads or tails out of the mess and asked for four more views. I was there, and I said I was going to do it, so I did it. I went back to the GYN and told her Never Again. She apologized.

    Yup, if it came down to men having their balls in a vise every year, you bet they’d figure something better out.

    Liked by 2 people

    Reply
    1. Zyp Czyk Post author

      Your gyn doesn’t seem to know that it’s cervical cancer that can become an issue if we take estradiol alone (like I do too), not breast cancer. It’s because the uterine lining can build up continually without progesterone to flush it out monthly. I was asked to do a uterine ultrasound exam, which was no big deal because I asked that it be external only.

      I didn’t want them using an internal probe and then to try twisting and squishing it around to get “better views” of my poor body with its defective connective tissue. My doc was sympathetic and allowed the external ultrasound only. I’ve been taking estradiol alone since 1998 to prevent horrific anxiety attacks from low estrogen. Weird, I know.

      I’m so sorry you were subjected to the torture of a mammogram – your description sounds just like I’d expect. I also have dense & lumpy breasts with great sensitivity to pressure and I’d be terrified. (Plus, dense breasts shouldn’t be scanned anyway since they can’t get a decent picture – see the earlier post about mammograms)

      Liked by 3 people

      Reply
      1. Laura P. Schulman, MD, MA

        Fortunately I am spayed, so I don’t have to worry about trouble from THOSE parts. The breast/estrogen issues are about estrogen receptor positive breast tumors. I do understand that concern, but I’d happily sign a lifetime waiver since I am an informed adult and I prefer the minuscule risk of feeding a cancer to the agony of having my pituitary gland trying to somehow kick my ovaries hard enough to….well, you know.

        The idea of an internal ultrasound probe…just the idea, mind you…triggers my rape trauma PTSD. Not on my shift! I’m glad you were able to avoid that.

        Liked by 2 people

        Reply
    1. Zyp Czyk Post author

      I hear each facility has different machines which can give the patient a wide variety of experience.

      The old ones had their pressure adjusted by a FOOT PEDAL, obviously for the technician’s convenience, despite the clear lack of sensitivity in our feet and the danger of accidentally stepping on it or dropping something on it.

      Liked by 1 person

      Reply
      1. Laura P. Schulman, MD, MA

        My cousin, who has very large breasts, was in the midst of a mammogram when a tornado struck the building. The power went out and she was clamped in the vise until the generator kicked in, what seemed an eternity later! Fortunately no-one was injured, but since she is a cancer survivor and has Q-six-monthly mammos, she does check the weather before going now….😨

        Liked by 2 people

        Reply
  2. painkills2

    I’ve never had a mammogram either. I checked into it at one point to see how painful it would be, and if I remember correctly, I was told of a new machine that didn’t even touch the skin. Some kind of scanner. But it was expensive and Medicare didn’t cover it.

    Before I would pay to have a test like that, I would ask myself: What if the test is positive? What are my options? What would I do? I can’t imagine that I would choose to spend the money to get treated, even if I had it. That I would take the risk that any of the treatments could cause more intractable pain. I’m sure I’m not the only pain patient who would see a cancer diagnosis as a possibility for getting adequate pain medication, but other than that, it wouldn’t mean that much. Except then I would have an estimate of when my pain will finally end.

    Liked by 1 person

    Reply
    1. Laura P. Schulman, MD, MA

      That’s very close to what I told my GYN when she tried to scare me with “cancer.” I said, so what, I wouldn’t treat it anyway. I would die in misery from the treatment. I’m not going to spend the last months of my life “battling cancer.” Everyone feels differently about these things, and I respect other people’s choices about how they want to live or die. So there.

      Liked by 1 person

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