Practical tips for a more comfortable mammogram

By now you’ve probably seen the internet jokes that compare the mammogram experience to having your breast squashed in a refrigerator door.  A few years back, I joined the club of women who have our annual mammograms, and I can’t say that I disagree with the imagery of the jokes.  However, the benefits of early detection far outweigh the discomfort, so I’m willing to put up with it.

I’d like to share a few tips I’ve learned as both the doctor and the patient, to make the experience a bit less awful:

  • If you are premenopausal and you experience breast tenderness or swelling in the week before/ during your period, schedule your mammogram appointment to avoid those times.
  • Take an over-the-counter pain med (Advil, Motrin, Tylenol, etc) about an hour before your mammogram appointment.
  • Don’t wear deodorant, cream or powder on the day of your mammogram.  It can show up on the films, and the radiologist can’t read them accurately.  You might get called to come back again on another day — inconvenient, and more radiation!  This is the mammogram of a woman who applied Desitin cream under her breasts, resulting in artifacts (arrows pointing to tiny white clusters of dots) on the films that looked like cancer.  She was called back, and after she cleaned her skin, the new pictures proved that there was no cancer, just Desitin.

Practical tips for a more comfortable mammogram

  • Best outfit to wear to a mammogram:  Two pieces (pants or skirt with a top) are better than one.  If you wear a dress, you must strip down completely, and sit in the “gowned waiting area” wearing a tiny paper (cloth if you’re lucky) ”gown” that barely covers the private bits.  Need I say more?
  • If you are having a breast ultrasound (sonogram) test, realize that the person performing the exam may be liberal with the gel that they must apply to your breasts during the test.  You may be very “goopy” afterward, and the construction-paper quality towels they provide might not cut it, especially if you are going back to work or you have other plans, and you can’t immediately return home to shower.  Several patients of mine, after confronting this situation and its ramifications, now bring their own supply of baby wipes to use after their test.  They either put a few in a ziploc bag, or bring one of those Huggies purse-size wipes containers.  Now you know.
  • If you are having a breast MRI, or any sort of needle biopsy, and you are at all anxious about it, ask your doctor to prescribe a mild anti-anxiety or sedative (Xanax, Valium, etc.) to take just before the test.  If you are comfortable, the test can be performed in less time, and often more accurately.

Stacey Vitiello is a radiologist who blogs at The Breast Diaries.

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  • elizabeth52

    I’d say before you even get to this topic, consider whether you really want to have a mammogram. Have you had a close look at the evidence and that means going way beyond what you’ll receive from your doctor or the screening authority?
    Sadly, screening has been pushed at women as something mandatory, for men it’s optional – in fact, informed consent is a legal and ethical requirement for all cancer screening and yes, that includes women.
    I was shocked to get to the facts and to this day feel angry and concerned that the test could be presented to me in such a biased and coercive way. There is still an underlying feeling that good women have screening and bad, reckless, irresponsible women don’t….absolute nonsense.

    We have to remember that profits, vested interests and politics are BIG features in cervical and breast cancer screening. Over-diagnosis is a serious concern with mammograms and new research suggests the fall in the death rate from breast cancer is about better treatments, and not screening. Of course, here in Australia the screening authority are chasing a target of screening 70% of women aged 50 to 69 – that’s their goal, forget our individual health and rights. Breast Screen recently reassured women they should have confidence in breast screening on the back of a Swedish study that showed less mortality in screened women over the long term. Of course, they completely omitted to mention a more recent study that showed the fall in the death rate was about better treatments. This selective use of research is unethical and terribly unfair to women – so many women trust doctors and the Govt to give them all the facts and properly advise them – in fact they tend to dismiss anything that might “put you off” screening, you only hear the bits that support screening.

    I made an informed decision not to have mammograms.
    I’d urge every woman to do some research and understand what you’re agreeing to…never let a doctor push you into screening – it’s your life, health, well-being, body and decision.
    Some references that helped me: The Nordic Cochrane Institute are an international, independent research group – they were so concerned at the misleading and incomplete nature of the screening brochures, they drafted their own – if I had my way, I’d send a copy to every woman in the world.
    http://www.cochrane.dk/
    “The risks and benefits of mammograms” has been translated into lots of different languages.

    My hero is a man called Prof Michael Baum, UK breast cancer surgeon – he helped set up the first breast screening clinic in the UK and ended up becoming an outstanding advocate for informed consent for women in cancer screening. He refuses to present a one-sided biased view of screening to women – he believes we’re entitled to all of the facts, even if that puts us off screening. He’s also concerned about over-diagnosis and the “stated” benefits of screening. He’s written many articles on informed consent and the risks of screening and has forced the NHS to make changes to better inform women – the fight continues. It’s shocking that in this day and age so many still accept that others should make decisions for women and accept risk on their behalf. That attitude does not exist in men’s cancer screening.
    “Scrap breast cancer screening” is an article written by Prof Baum, just after the latest research was released…
    http://www.guardian.co.uk/commentisfree/2011/aug/02/breast-cancer-screening?INTCMP=SRCH
    http://www.bmj.com/content/343/bmj.d4411

    Prof Baum and others are also taking legal action against the NHS for failing to obtain informed consent from women before screening. Thanks to doctors like Prof Baum, brave enough to take on the powerful screening lobby, women can now make informed decisions about screening.
    Beware: be VERY careful agreeing to breast screening before age 50 and then only 2 or 3 yearly. American doctors tend to over-do everything and that just ends up harming and worrying lots of people. Your Dr Gilbert Welch has the right idea…he’s also covered the risks and benefits of breast screening in his latest book, “Over-diagnosed”.
    http://www.ucl.ac.uk/lhl/lhlpub_autumn10/06_28102010
    (Informative lecture given by Prof Michael Baum at UCL recently, “Breast cancer screening: the inconvenient truths”.
    Make up your own mind…