Yesterday I had my annual mammogram. I was 9 months overdue. To my chagrin I realized it’s because I’ve started to have a trauma response when I go. It’s not from past abuse…at least not from who you may think. It’s from the procedure itself.
I’m no baby. I was disabled with a herniated disc for a year in 2015-2016, and I overheard my doctor telling my partner that I was very tough in that department, I asked for very little pain medication compared to other people. I was surprised, to be honest. It was something I didn’t know about myself.
With all this in mind, yesterday I went in there determined to advocate for myself. I talked to my technician, (I’ll call her Luna) who was there with the standard ready jokes to calm patients. I told her that I felt that my breasts have been damaged, and not just hurt, by past procedures and that I experience real pain. Luna assured me that she would stop compression on my say so, and we began.
Despite Luna’s assurances, when the time came, she did not stop compression when I asked. She cranked down past my “stop.” I was literally yelling, “Stop! Stop! Let it up! Take it up!” and she did not immediately respond. When she finally did I had tears running down my face. When I left there, I felt as if I’d been through an ordeal. I wondered, how many others feel this way, and we just don’t talk about it, thinking we are being dramatic? Are we aided in this thinking by a medical establishment with a long and inexcusable history of ignoring female pain?
I called my bestie, and she told me that not only does she have the same experience, but everyone she knows feels similarly.
So I did what I do. I researched the question.
Mammography compression, it turns out, uses up to to forty-five pounds of compression (1), and studies about mammography pain have put it on the pain range of 74-93%. Another study found that 15% of people experienced severe pain, despite the fact that almost a third took pain medication or tranquilizers before the procedure (2) (at the advice of doctors…so they must know). Another two studies I looked at were concerned that mammography compression could cause tissue damage (not a surprise to me).
As a lifetime health educator and a person with a family history of breast cancer, I am aware that early detection is crucial, and I don't want to deter people from getting screened. But I, like the 90% of others who have either areas of dense breast tissue or dense breasts in general, probably experience more significant pain than those who do not at compression time (2) . I am tired of it. How many of us avoid mammograms or delay them out of fear, and put ourselves at risk because of it? Are there alternatives?
As it turns out, there are. They are just not widely known or practiced. Ultrasound is not the best option, it turns out (I asked for that first). It can’t catch cancer when it is in its earliest stages, although it’s good at secondary diagnosis once cancer has been found or is suspected.
One study I looked at from Duke University (3) combined SPECT scanning with CT scans, and Duke was looking into this technology at the time it was written (2015). SPECT-CT is painless, and the results are as good or superior to those of mammography. In addition it uses significantly less radiation. A later article that interviews Dr. Mary Slavatore and Dr. Elise Desperito at Columbia University from 2022 showed that CT scans alone may be adequate at this point, because of the improvement in CT technology. The radiation from CT is comparable to mammography (4).
At the moment, I have no idea whether I can get a CT scan instead of a mammo next time. I have to call my doctor and ask. I imagine they will say they don’t do that, it’s outside of standard protocol. Then again, I am reminded that several thousand people read this blog each time I send it out, and many of them have mammograms. I wonder what would happen if enough of us started to demand better, less painful diagnostic procedures? What if we spread the word, started talking to our doctors more seriously about our pain, didn’t allow them to minimize or dismiss it so easily? What if we asked them to run it up the chain at their clinic, hospital, or practice?
Suddenly, I am smiling as I write. Just wait till next year.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015182/
- Johannes P. van Netten, Stephen A. Cann, James G. Hall, Mammography Controversies: Time for Informed Consent?, JNCI: Journal of the National Cancer Institute, Volume 89, Issue 15, 6 August 1997, Pages 1164–1165, https://doi.org/10.1093/jnci/89.15.1164-a
- [1] https://www.dukehealth.org/blog/painless-alternative-mammogram-works
- https://www.health.com/mind-body/6-key-medical-scans-and-what-they-should-cost
- https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/experimental-breast-imaging.html#:~:text=The%20most%20commonly%20used%20breast,being%20developed%20for%20breast%20imaging.
