Let's reinvent the mammogram so it isn't effing torture!

In My Humble Opinion
1

I was diagnosed with breast cancer in March 2015 (IDC < 1cm, lumpectomy, 3 wks radiation, no chemo, 5 years of Arimidex, 2 biopsies since, no more cancer found), and I’ve had LOTS of mammograms. Yesterday I had my annual, and it was the most painful one I’ve ever had.

For those who don’t know, the technician puts each breast between a hard plastic tray and a metal shelf and cranks-cranks-cranks the two together until your breast is as flat as it is possible to get a live, round thing, and then they take an x-ray. This happens with each breast 2-3 times at slightly different angles. The picture below portrays the procedure as much more gentle than it really is. There’s lots of heaving and pushing and tugging and shifting of tissue to get it in exactly the right place for the best picture. Then the cranking of the two plates together – right out of the Spanish Inquisition.

IT. FUCKING. HURTS.

Every mammogram hurts some, but yesterday’s… Jesus Henry Christ! At one point I told her, “Don’t crank it down any more, I can’t take it!” and burst into tears. Have you ever slammed your hand in a door? Well, this is doing it in slow motion.

The technician showed me the screen and why she had to keep doing the left side over and over. I have a lot of markers and debris in that breast left over from the lumpectomy. (How did you THINK the surgeon was supposed to find that spot again that the radiologist located during the biopsy, hmmm?) I knew why she was doing it, and I swear she was in almost as much distress as I was (minus the physical pain, of course), and she kept apologizing for the torture. I WANTED her to get as much of my breast in the picture as possible. But holy fuck-- there has got to be a less painful, more humane way of doing this!

Why do the two surfaces have to be hard and flat? This is rounded, living tissue we’re squishing here. Why can’t there be a layer of foam or something with some “give” to it. Don’t tell me an x-ray can’t see through a couple of layers of foam.

Here comes a sexist statement (but probably true): “It is estimated that 48 million mammograms are performed each year in the United States.” Needless to say, these are virtually all on women.

If 48 million MEN every year underwent a procedure as painful as this (say, squishing their nuts between a hard piece of plastic and a hard piece of metal several times to get an x-ray), you can be g.d. sure some guy would invent a better, less painful way of getting the same information. Or at least a way of making the procedure less painful. :angry: Don’t bother jumping all over my face and asking why a woman hasn’t improved the procedure. I don’t fucking know, but someone needs to.

My left breast is sore and bruised today. It feels like I’ve been punched in my left side at the top of my rib cage.

My mammogram was all clear, and I’m grateful-- very grateful. I sweat this every year now since I got The Diagnosis back yonder. I’m NOT tempted to skip it, but there has got to be a way to make it less painful.

2

I am no techie but I wonder why there can’t be a 3D Xray that requires no breast compression but rather a machine that takes multiple angle Xrays and forms a composite image, showing everything in 3D. If anything, this would be even more accurate because it shows the breast as it actually naturally is, not in an artificially flattened state. Unless the radiation is too much to be safe.

3

I just had a CT scan of my head, which is basically what you’re describing. They said the dose was much lower than a conventional X-ray. I don’t know why 3D imaging like CT or MRI couldn’t be applied to breast scans. My guess is that, at 48,000,000 scans a year, it comes down to $$$.

4

I’m so sorry for the process, but glad for yesterday’s negative findings.

FYI … your concerns are being heard:

[I think the OneBox thing tells the basics well enough …]

Now, if you’ll excuse me, I have to go forcefully slam my nuts between the M and S volumes of the World Book Encyclopedia …

because you gotta’ have hobbies

5

That’s shitty, and you’re totally right that change in this area has likely been a low priority because women’s issues are always low priority, along with a generous helping of: “if it is effective now, why invest money in a new solution for the purposes of increased comfort only?”

A tangential question that maybe someone can answer . . . not all women have large enough breasts to, um, be manipulated in a way that ThelmaLou describes. How does a mammogram work when there isn’t enough mailable tissue to get into the x-ray device and/or be compressed as described here?

6

I am very glad you posted this.

I’m a guy, and was always confused by why so many women of the right age did not want mammograms. For obvious reasons I’m not going to see one in action (not a doctor) so I didn’t know one reason is a sensitive part of her anatomy is getting squished.

I guess that might be like getting some part of my anatomy crushed for a prolonged period of time. Ouch. Yeah, that needs fixing!

7

My experience has been the same as the OP’s. A few weeks ago, the radiology tech told me the 3D mammogram was developed by women.

Glad to learn there’s a painless alternative in development.

8

I wonder about that myself, and if I hadn’t been in so much pain, I’d have asked the technician.

Sorry if this is TMI, but my girls are pretty average- B cup. The left one is a little smaller because of the lumpectomy, but that’s okay, 'cause now there’s room for me to tuck a hanky (yes, I still use cotton ones) or my car keys in my bra on that side. :wink: So I definitely wonder about very small breasts, but what about ginormous ones? Yikes! That must hurt a lot, too! I know that men can get breast cancer. Is that diagnosed with a mammogram? I’m guessing not. Probably with a sonogram followed by an MRI.

Mine WAS a 3D mammogram. The results are said to be clearer, but the painful procedure was exactly the same as in all my past mammograms.

9

Oh, I had tears streaming down my face, believe me. My point was not that the 3D kind is less painful but that women developed it. (I think it was two women and a man, but I can’t find where I saw that.) I found it a little faster and considerably less awkward but no more comfortable. Like you, I’m a breast cancer survivor, and the fact the 3D is better diagnostically is worth a lot, but yikes, the pain!

Fifteen years ago, I had to have a surgical biopsy of microcalcifications in one breast. (They were benign.) Just prior to surgery, I had to have a mammogram–traditional back then–to find and mark the spot. They had trouble finding them, there was some holdup with the radiologist, and the techs left me crying in the machine for a full 30 minutes. They kept apologizing but wouldn’t take me out of the damned machine. Hell. On. Earth.

10

Looks like another ‘painless’ approach is in the works, too:

https://www.nibib.nih.gov/news-events/newsroom/light-based-15-second-scan-aims-replace-painful-mammograms

Up to 50% of women skip potentially life-saving mammograms often because the procedure can cause extreme discomfort and pain. Now researchers have developed a painless, light-based, non-radioactive, 15-second procedure that could revolutionize breast cancer screening and save lives.

11

:scream:

This one and the one cited above look promising. Let’s get a move on!

12

I’m glad there are more painless alternatives in the works. The last hospital I worked at had an on-site Radiologist who frequently required support.

I saw many mammo images during my time working with him (not that they’re particularly interesting). They all look like many-layered blobs of white ‘spaghetti’ which the doc has to comb through to find discrepancies. After seeing them I can understand why they would need them to be as flat as possible. Flatter = fewer ‘layers’ the doctor is trying to see through.

Edit: Yes, men also get mammograms.

13

I never question the need for the breast to be made as flat as possible, just the practicality of flattening something that nature has made three-dimensional and round.

Reading an x-ray is definitely an art! No quibble there either. I liken it to the way Mark Twain learned to “read the river.”

14

Maybe you misheard? CT is usually a vastly higher radiation dosage than an X-ray.

15

I did not mishear. He possibly lied.

16

We could keep the equipment, but make mammogram day a spa day. You get a mammogram (which is painful) but also a massage and a mani pedi, etc.

The place I go gives you a little chocolate, and its sort of amazing how much just a little understanding and chocolate helps. (Vodka tonics would be better, but they probably aren’t hospital appropriate. But I don’t know why they couldn’t dose you with a little painkiller and some anti anxiety meds before hand).

The current widely used speculum has not been reinvented for a century and a half. But someone came up with one. Yah know…just something that isn’t metal that pinches the sides of the inside of your vagina during use might be good.
These innovative designs are tackling taboo health issues for women - CNN Style

17

I agree, there needs to be a better and less painful method for doing this. The last mammo I had left me with a bruised shoulder and torn skin under my arm (the suspected lump was up higher on the breast and required more pulling and shoving down of plates). Yegods that hurt! Maybe someone should invent something like a plunger scanner, you know, just take a toilet plunger and put some imgaging stuff all around the cup. SSSHHHCHLOOP! “Okay that’s done, now the other one!” And I like the spa day idea too.

18

I have the same question about MRIs. Which are basically the same idea as an iron lung, albeit more temporary. They do have some of the ‘open’ ones now, which are better. The valium I was prescribed last time helped a lot too. But still, there’s got to be a better way.

19

I’m a guy, but imagining a giant suction cup attached to / surrounding the typical female breast then the tech pulling the darn thing off with a mighty yank sounds pretty ungood to me.

20

Or like when men need mammograms because they have suspected or actual breast cancer?

They pinch as much as they can between the plates to get an image (yeah, I asked one time).

I’m also going to point out that while mammograms are never fun and not comfortable, not everyone experiences them as painfully as the OP. Me, for example - not fun getting it done but I have never experienced what I could call pain. It’s not getting a hand slammed in the door sort of sensation, more a feeling of weight/compression than is uncomfortable but not agony. Sort of like having someone really heavy sit in your lap - it’s comfortable and you can’t get away but it’s not actually painful.

Not that I’d pass up something more comfortable.

I also fully believe those women who describe it as agony, because for many it is. Sensitivity varies between women, and a breast with a problem may be more likely to react painfully to being squeezed.

Nope, men with breast cancer get mammograms, too. The two places I’ve gone for mammograms both had a changing room for men as well as women.