Mammograms: A Little Pain for A Lot of Gain
]]>Breast cancer]]> is the leading cancer in women, and the second-leading cause of cancer death in women. In 2002, breast cancer was responsible for about 40,000 American deaths.
The good news is that breast cancer, when caught early and treated appropriately, is highly curable. The five-year survival rate for localized breast cancer is 96% and it is 78% for cancer that remains confined to the breast. On the other hand, once breast cancer spreads beyond the breast and lymph nodes, the survival rate drops to 21%.
Most studies have shown that ]]>mammograms]]> can reduce the risk of dying from breast cancer, and most health organizations recommend that women have a yearly mammogram beginning at age 50. But women aged 60 and older, who are most likely to benefit from mammography screening, are less likely than younger women to have been recently screened. Both women and their physicians report that the associated pain is a significant barrier to regular mammograms.
In a study published in the April 14, 2003 Archives of Internal Medicine , women who were interviewed immediately after their mammograms reported a relatively low level of pain from the procedure.
About the Study
Researchers interviewed 200 women, aged 40 and older (average age 59.2 years), immediately following their screening mammograms.
The women were asked to rank the amount of overall pain they experienced during the procedure as well as pain experienced during specific parts of the procedure. They were asked to report pain on a scale of 0 to 10, which was described as follows:
- 0 = no pain at all
- 5 = average pain (for example, a mild headache or shoes that are a little too tight)
- 10 = the worst pain you have ever felt in your life
The women were also asked what they felt was the greatest source of stress surrounding the exam, and whether their caffeine consumption had varied from normal in the three days preceding the mammogram (women concerned about pain are often told to limit their caffeine consumption for a few days before a mammogram). Finally, the researchers obtained each woman’s height, weight, and bra size.
Seventy-two percent of the women interviewed ranked their pain as a 4 on a scale of 0 to 10 (the average score was 3). Ninety-six percent of the women said the pain was “less than” or “about as expected.” The most painful part of the procedure was compression of the breasts. Most of the women (94%) said they were “very likely or somewhat likely to get a mammogram next year.”
The researchers found no correlation between the amount of caffeine consumed and reported pain. And, despite the widespread belief that women with larger breasts experience more pain during mammography, no connection was found between breast size (bra size or cup size) and reported pain. Premenopausal women reported significantly more pain if their last menstrual period occurred within eight to 14 days of the mammogram.
The most stressful part of the process was found to be waiting for the results of the mammography.
How Does This Affect You?
The women enrolled in this study reported the pain of a mammogram to be, on average, less than the pain associated with a mild headache or a slightly tight pair of shoes. So if anticipated pain is holding you back from having regular mammograms, this study should put your mind at ease and motivate you to make an appointment. Physicians should take note of these results and inform their patients that the benefits of regular mammograms, particularly in older women, appear to outweigh the risks and discomforts associated with the procedure.
Steps should also be taken to minimize the waiting period between the mammogram and delivery of results. In the meantime, doctors may ease their patients’ fears by explaining that only about 5 out of every 1000 women screened is found to have breast cancer.
American Cancer Society
National Cancer Institute
National Institutes of Health
Sharp PC, et al. Reported pain following mammography screening. Arch Intern Med . 2003;163:833-836.
Last reviewed Apr 16, 2003 by ]]>Richard Glickman-Simon, MD]]>
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