• St. Mary Medical Center's Lisa Simpson: When pain keeps you from a mammogram

  • Getting a mammogram may be up there on your list of least favorite medical screenings. But for some women, even the prospect of pain or discomfort is enough to keep them from having this annual evaluation.

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  • Getting a mammogram may be up there on your list of least favorite medical screenings. But for some women, even the prospect of pain or discomfort is enough to keep them from having this annual evaluation.
    Mammograms are a regular part of women’s health and are done as a screening tool for breast cancer. The National Cancer Institute recommends that women age 40 or older have screening mammograms every one to two years. Also, women who are at higher than average risk of breast cancer because of a family history of the disease or because they carry a known mutation in either the BRCA1or the BRCA2 gene should talk with their doctor about whether to have mammograms before age 40 and how often to have them.
    During a screening mammogram, a woman’s breast is compressed with a special machine. Images are taken from different angles of each breast with special X-ray film that is designed for breast tissue. Through this procedure, abnormal growths or tissue can be seen.
    Besides an abnormal growth, signs of breast cancer can include breast pain, thickening of the skin of the breast, nipple discharge or a change in breast size or shape; however, these signs may also be benign conditions. A diagnostic mammogram can be used to evaluate changes found during a screening mammogram or to view breast tissue when it is difficult to obtain a screening mammogram because of special circumstances, such as the presence of breast implants. Implants can sometimes hide some breast tissue, making it more difficult for the radiologist to detect an abnormality on the mammogram.
    Because the breast must be compressed in order to get a good picture of the tissue, mammograms may be uncomfortable. About 10 percent of women, particularly women with large breasts, say that mammograms are actually painful. Much of that is related to fibrocystic (an overgrowth of fibrous tissue and cystic spaces) changes in the breast, most common for women in their 40s, which tends to improve after menopause.
    I believe in talking with our patients. Talking with the technician about the procedure and expectations can go a long way toward alleviating psychological barriers to mammograms. Often, if you think it’s going to be painful, you will likely have that experience. Communicating throughout the procedure also helps in the process. Pain can be minimized by something as simple as repositioning the breast. Don’t feel shy about talking about what you are feeling. For those concerned with exposure to radiation, they should know that they are receiving less radiation during a mammogram than a typical X-ray.
    Some other things to consider to help make your mammogram more comfortable:
    • Schedule your mammogram after you start your period.
    About 10 days after your period begins is the best time to have a mammogram. The breasts are usually less tender, reducing the amount of pain you will experience.
    Page 2 of 2 - • Consider over-the-counter pain relievers prior to the mammogram.
    About an hour before your mammogram, take an over-the-counter pain reliever, such as acetaminophen or ibuprofen. It can help with the pain. Be sure to talk to your doctor before taking any medications.
    • Avoid caffeine.
    Since caffeine can make your breasts tender, consider drinking decaf coffees and soft drinks about a week before your next mammogram.
    In addition to these tips, be careful not to wear lotions, deodorants or creams on your chest before mammography, which could conflict with the imaging quality.
    As you need to be undressed from the waist up, wear a two-piece outfit that will be easy to remove and put back on.
    Getting a high-quality screening mammogram and a clinical breast exam (done by a health care provider) on a regular basis are the most effective ways to detect breast cancer early. As with any screening test, screening mammograms have both benefits and limitations. For example, some cancers cannot be detected by a screening mammogram but may be found by a clinical breast exam. There is a chance of false positives and false negatives, but overall mammograms are still your best bet for detecting cancers and getting early treatment.
    And, don’t forget the Breast Center at St. Mary’s Medical Center offers walk-in mammograms Monday-Thursday, 8-11:30 a.m., and 1-4 p.m.
    Lisa Simpson, RT(M), is a mammography technician in the Breast Center at St. Mary’s and can be reached at 816-655-5566.

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