All About Mammograms
Breast cancer screening is meant to detect breast cancer at an early stage - before a person has symptoms. This is important because cancers that are diagnosed at an early stage are more likely to be cured. Breast cancer screening is not only important for people who have a family history of cancer, as 1 in every 8 women in the United States will be diagnosed with breast cancer in their lifetime. So naturally when my gynecologist asked me, a recently turned 40 year old woman, if I would go get a screening mammogram, I confidently answered “of course”.
As a gynecologist myself, I have referred thousands of women for mammograms and for some reason I looked forward to my first one. There was the obvious reason for wanting to be proactive about my health, but also important for me was being able to relate to my patients. For years patients would tell me about how much they hate going for mammograms, how uncomfortable it is, and how they believed that if men had to do them routinely, it would be less uncomfortable. In these moments,I could only agree that I have heard that they may hurt or be uncomfortable,agree that we need to find less uncomfortable screening tools, and hopefully give a speech motivating enough about the importance of screening tests and therefore mammograms. But I knew once I got a mammogram done myself I would be empowered with my own personal experience, and that is commonly the best anxiety-relieving tool I have. If I’m being honest, I was a bit concerned about how uncomfortable it would be, but like I always tell my patients, being nervous was normal.
Screening mammograms essentially take pictures of the inside of the breast, in order to find tumors that are too small to feel. Believe it or not the technology used in mammograms have come a long way since they were invented in 1913. Newer digital mammograms were first developed in the 1990s and approved by the FDA in the year 2000. 3D mammograms were approved as recently as 2011, and have become the most common type of mammogram performed. Mammograms do expose a person to radiation, but a very small amount, and the benefits of getting a mammogram are far greater than any risks.
I must confess, I had never looked up what a mammogram machine looks like, I simply knew that it squishes the breast. So I was happy that the machine looked less like the medieval torture device than I expected. Thankfully, I had a pleasant mammogram technician who guided me through the exam. The most difficult part of the exam for me was actually not trying to help the technician. I found that when I tried to anticipate how she was trying to position the breast on the bottom surface (plate), she would have to tell me to step back and start again. When I simply allowed her to move and mold my breast as she needed to and move when and where she told me to, the exam went very quickly. Once she had the breast positioned on the bottom plate, she attached the top plate and lowered it onto the breast. I took a deep breath anticipating pain as she lowered the top plate, but to my surprise, the anticipation was way worse than reality and I was in that position for less than 30 seconds (or so it seemed). After the first picture, the other three seemed to breeze by.
As a doctor, I believe my patients, so I wondered what could have contributed to my exam having minimal discomfort. Here are some tips I found that may minimize the pain experienced during a mammogram.
1. Try to schedule your mammogram 1 to 2 weeks after the first day of your period.
2. Limit your salt and caffeine intake 1 to 2 weeks before your exam as these can make breasts more tender.
3. Be upfront with the technician about any pain that you are experiencing prior to the exam.
4. Take an over the counter pain medication an hour before the test.
5. Practice your breathing exercises.
Like every other screening test, mammograms are not 100 percent effective at detecting breast cancer, and factors such as having dense breasts may limit how accurate the test is. Therefore, it is important to know and discuss your family history with your doctor, practice breast self awareness and inform your doctor of any changes you may notice in your breast. Your doctor will also perform a clinical breast exam (a breast exam performed by a physician or other clinician) during wellness visits, and help determine if other screening tests such as a breast ultrasound or MRI is appropriate. Your doctor may also recommend genetic testing if you have a strong family history of breast or ovarian cancer.
In conclusion, as a woman with an average breast cancer risk, I had a screening mammogram at age 40 and plan to do so every year. I recommend that you discuss breast cancer screening at your next wellness visit and determine at what age you will start getting mammograms and at what frequency. As a gynecologist, I follow the guidelines set by the American College of Obstetricians and Gynecologists (ACOG), and recommend that my patients get mammograms once a year starting at age 40. Varying organizations may differ slightly in their recommendations, but they all agree that breast cancer screening with mammograms should begin by age 50 and at least every 2 years. Whatever your preference, be sure to discuss it with your regular doctor and have a plan.
As always, you can discuss this topic with myself or another Kiira expert on our app.