"Why was my mammogram uncomfortable?" 

 

This column will explain why and also share a few tips on how to minimize the discomfort.

Firstly, when you think about a breast, the part near the chest wall is thicker than the part near the nipple.  However, when you have a mammogram only one "exposure" is taken to image the breast. We have to deal with trying to get the "best picture" while having the challenge of a part of the body with different thickness. The way this is dealt with is that the breast is "squeezed" so that the thickness of the breast is more uniform and therefore the x-ray exposure can be optimized to get the clearest picture that allows for the best diagnosis. 
 
The second reason also has to do with the x-ray exposure. The thinner the breast the less the radiation dose needed to get the quality image that is necessary to diagnose those smallest, earliest and most curable breast cancers.  The "squeeze" makes the breast thinner and allows for a lower dose of x-ray while still getting the best picture.  It is important to remember that the dose the breast receives during a mammogram is less than flying from one coast to the other (by virtue of being closer to the sun).  Although the dose is extremely small, we still do all we can to minimize the dose.
 
Finally, the third reason is less well publicized.  When we interpret a mammogram, we are looking for the very smallest calcifications. Calcifications are much like tiny specks that look much like talc powder.  If there is even the slightest motion, the resulting blur can make the microcalcifications not visible. Therefore, the squeeze is in fact, a vice, to assure that there is no motion and therefore, we can see even the smallest of calcifications. This would allow us to diagnose the earliest breast cancer.
 
So, now you know why, but how can you minimize the discomfort. Firstly, if you are pre-menopausal, schedule your mammogram right after your period, when your breasts are least sensitive.  Secondly, if you have experienced significant discomfort during past mammograms, take either extra strength acetaminophen (Tylenol) or Motrin 1 hour prior to the mammogram. It won't eliminate the discomfort, but it will take the edge off.
 
Most importantly, it is critical to remember that even thought there is the "squeeze", it is imperative that you get your yearly mammograms. If you skip the "squeeze", you skip the mammogram and you therefore skip the opportunity to save your life!!!!