Women Report Little Pain During Mammograms

Some Women Anticipate Problems

Women often avoid getting mammograms because they are afraid of the pain, but the fear is unfounded, according to report in the Archives of Internal Medicine. 

The study was based on interviews with 200 women over the age of 40 immediately after they had mammograms. About 72 percent of them had pain, but most characterized it as mild.

Researchers say they hope the research helps dispel myths about pain associated with mammograms and, in turn, encourages more women to get them.

"Pain is listed as one of the main barriers to women getting mammograms," says lead researcher Dr. Penny Sharp, an associate professor of family medicine at Wake Forest University. "When women get together, they talk about how painful they are; the topic of pain always comes up."

But, Dr. Sharp adds, "If the pain is not as bad as women have said in the past ... it may not be quite as much of a barrier. Removing any barriers to women receiving these tests is important."

Mammograms Save Lives

Screening mammograms - X-rays of the breast - can detect clues to breast cancer among women who have no signs or symptoms of the disease, and early detection can be crucial.

The National Cancer Institute (NCI) points to research that has shown mammogram screenings reduce the number of deaths from breast cancer for women aged 40 to 69, especially those over age 50.

The NCI recommends that women 40 and older have mammograms every one to two years. The American Cancer Society (ACS) recommends that women 40 and older have mammograms every year.

Breast cancer is the most common cancer among US women (behind skin cancer), and the second-leading cause of cancer deaths, according to the ACS.

Nearly 40,000 women are expected to die of breast cancer this year, and more than 211,000 are expected to have the disease, the ACS estimates.

Many Women Said Procedure "Not Bad at All"

In the current study, those who reported pain rated it on a scale of one (no pain) to 10 ("the worst pain you've ever felt"). The level of pain averaged four, with five classified "about average" - resembling the pain intensity caused by a mild headache or wearing shoes that are a little too tight, the study says.

Of all the women screened at the center, 94 percent said they probably would get another mammogram the next year; only 2 percent, mostly younger women, said they would not.

Contrary to popular opinion, the study found no relation between consumption of caffeine before a mammogram and the level of pain.

The study did establish a direct connection between level of pain and the last menstrual period. Women who had periods within eight to 14 days of the mammograms reported significantly more pain.

Asked what aspects of the screening process bothered them, 39 percent listed waiting for results, compared with 25 percent who cited actually getting the mammogram.

Researchers found no correlation between pain during mammograms and age, race, breast size, body-mass index (BMI) or presence of medical conditions. Even those who said they were sensitive to pain did not report higher levels than other women, the study found.

Dr. Susan K. Boolbol, a breast surgeon at the Cancer Center of Beth Israel Medical Center in New York City, says the study reinforces the message that reports of mammogram pain are greatly exaggerated.

"The myth associated with mammograms is that they are incredibly painful," Dr. Boolbol says. "We hear frequently from patients that, 'I thought it would be terrible, but it wasn't bad at all.'"

"A lot of what we do is educate patients, and this study adds to the education of patients," she says. "Anything that helps us educate the public and helps patients get mammograms is important."

Always consult your physician for more information.

Online Resources

American Cancer Society

American Society for Clinical Oncology

Centers for Disease Control and Prevention (CDC)

National Cancer Institute

National Institutes of Health (NIH)

National Women's Health Information Center 

June 2004

Women Report Little Pain From Mammograms, Study Shows

Mammograms Save Lives

Many Women Said Procedure "Not Bad at All"

Breast Health: Three-Step Plan for Preventive Care

Online Resources

Other Resources:

St. John's Mercy Cancer Services

Find a St. John's Mercy Physician

Breast Health Information

Women's Health Information

St. John's Mercy Classes and Programs

Breast Health: Three-Step Plan for Preventive Care

Although there are some women who are at higher risk, the fact is that all women are at risk for breast cancer.

That is why it is so important to follow this three-step plan for preventive care. Although breast cancer cannot be prevented at the present time, early detection of problems provides the greatest possibility of successful treatment.

Routine care is the best way to keep you and your breasts healthy. Although detecting breast cancer at its earliest stages is the main goal of routine breast care, other benign conditions, such as fibrocystic breasts, are often discovered through routine care.

Step 1. Breast Self-Examination (BSE) 
A woman should begin practicing breast self-examination by the age of 20 and continue the practice throughout her life - even during pregnancy and after menopause.

BSE should be done regularly at the same time every month. Regular BSE teaches you to know how your breasts normally feel so that you can more readily detect any change.

Changes may include:

• development of a lump
  
  
• a discharge other than breast milk
  
  
• swelling of the breast
  
  
• skin irritation or dimpling
  
  
• nipple abnormalities (such as pain, redness, scaliness, or turning inward)

If you notice any of these changes, see your healthcare provider as soon as possible for evaluation.
 
Step 2. Clinical Examination
 
A breast examination by a physician or nurse trained to evaluate breast problems should be part of a woman's physical examination.

The American Cancer Society (ACS) recommends that women between the ages of 20 and 39 should have a clinical breast examination by a health professional every three years. After age 40, women should have a breast examination by a health professional every year.

A physical breast examination by a physician or nurse is very similar to the procedures used for breast self-examination. Women who routinely practice BSE will be prepared to ask questions and have their concerns addressed during this time.
 
Step 3. Mammography
 
Mammography is a low-dose x-ray of the breasts to find changes that may occur. It is the most common imaging technique. Mammography can detect cancer or other problems before a lump becomes large enough to be felt, as well as assist in the diagnosis of other breast problems. However, a biopsy is required to confirm the presence of cancer.

Since there is controversy among cancer organizations regarding when to begin having mammograms, as well as how often, talk with your physician about a mammography schedule that is appropriate for you based on your overall health and medical history, risk factors, and personal opinion or preference.

According to the National Cancer Institute, women in their 40s and older should begin having a screening mammogram on a regular basis, every one to two years. But, the ACS recommends that by age 40, women should have a screening mammogram every year. (A diagnostic mammogram may be required when a questionable area is found during a screening mammogram.)

Both organizations suggest that women who may be at increased risk for breast cancer should talk with their physicians about whether to begin having mammograms at an earlier age.

Always consult your physician for more information.