Mammogram angst, for many women, begins with the appointment reminder notice. It frequently worsens until the patient is sitting in my office with Kleenex, crying tears of relief as I have just told her that her exam is “normal.”
Why is this exam so difficult for us all — and that includes the spouses and significant others connected to the person getting it? Just some of the contributors: This is an emotionally-engaging exam that determines “normalcy” of a very female part of our bodies. This is a sometimes-painful exam that makes us feel like we will never quite “fluff back out” again. Because we begin to “feel new lumps” that naturally lead us to worry. Because mammograms take time out of our already over-scheduled day. Because pink ribbons are everywhere reminding us that someone we know or love has had breast cancer.
Here are my top tips that will make your mammogram exams better – or at least more tolerable – since I don’t see them going away in the near future:
- If you are of menstruating age, schedule your screening mammogram approximately 7-10 days after your menstrual cycle begins, when you will be at your lowest in hormone levels, a part of your cycle when your breasts are the least tender and lumpy.
- If scheduling your mammogram at a new breast center, be sure to have all available prior mammograms (the pictures, on a CD) at your appointment. Most facilities will try to locate prior exams and transfer them for you, upon your signature consent, but this takes time and will delay interpretation of your exam by up to 2 weeks – more sleep loss! This may mean requesting mammogram reports from your primary care physician in advance in order to know the name and address of the facility that last did your exam, but it is worth it. This step can help prevent unnecessary callback exams, which occur 260 percent more often when prior comparisons are not available.
- If you are particularly tender, or have known fibrocystic disease, limit the amount of caffeine you drink in the few days leading up to the exam. Schedule the exam in the morning, when cysts (fluid-filled structures that may be tender) are their smallest. You may also take an anti-inflammatory medicine such as ibuprofen, on a full stomach, approximately 2 hours before the exam, which can reduce pain during the compression.
- Have a good breakfast or lunch, or pack a snack. Hunger does not make this exam better.
- Recognize that if something is detected on mammograms, it is almost always curable 96 to 99 percent of the time, and that cure isn’t necessarily chemotherapy.
- Wear a shirt that buttons up the front or is easily removed. Wear shoes that make you feel good (which always helps, strangely), but not high heels that cause you to teeter (pun intended) during the exam.
- Bring a good book or magazine, or strike up a conversation with your fellow patients in the waiting room. Distraction is always good. Patients who are particularly anxious may wish to focus on breathing and meditative techniques.
- After entering the exam room, strike up a conversation with your technologist, who will soon be positioning your breasts for the best picture. They are typically caring, compassionate women who want to make the experience as pleasant as possible.
- If you are particularly sensitive to mammography compression, wiggle your fingers or toes – distracting your mind – while otherwise holding extremely still. You do not want to have to repeat the picture because of breathing or chest motion.
- When you are free to leave, remember that only about five out of every thousand patients screened that day have breast cancer — you have pretty great odds. Even when additional testing (the dreaded “Callback”) is recommended, about 95 percent have no breast cancer. The goal is to detect breast cancer early, so that no woman has to endure the problems of late-stage diagnoses.
- When you receive your report, look at the wording of your breast tissue density findings. If “extremely dense” or “heterogeneously dense” shows up, consider talking to your physician about your individual risk for breast cancer and possible needs for additional screening tests, such as ultrasound or MRI. Digital breast tomosynthesis (3-D mammograms) are preferable for women with dense breast tissue.
We all agree that mammograms are a source of frustration and angst for most of us. However, with proper preparation and planning, this process can be more tolerable and pleasant, and it may save your life.