Most Women Report Mammogram Pain As Mild

 Menstrual Period and Mammogram Timing Could Affect Pain Levels, Study Finds

Women often avoid getting mammograms because they're afraid of the pain, but the fear is unfounded, according to a new study in Archives of Internal Medicine.

The findings were 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.

Those who reported pain rated it on a scale of 1 (no pain) to 10 ("the worst pain you've ever felt"). The level of pain averaged 4, with 5 classified "about average." This was similar to the pain intensity caused by a mild headache or wearing shoes that are a little too tight, the study says.

Women Say Mammogram Pain a Concern

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

But, 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."

Sharp says physicians will be hopeful that the research helps dispel concerns about pain associated with mammograms and, in turn, encourage more women to get them.

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 relationship 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, or presence of other medical conditions. Even those who said they were sensitive to pain did not report higher levels than other women, the study found.

Early Detection Can Save Lives, Experts Say

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

Many experts say research has shown mammogram screenings reduce the number of deaths from breast cancer. The National Cancer Institute (NCI) recommends that women 40 and older have mammograms every one to two years.

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

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

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," 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

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Archives of Internal Medicine

American Cancer Society

Breast Cancer Prevention Trial

National Cancer Institute

National Institutes of Health (NIH)

National Women's Health Information Center

May 2003

Menstrual Period and Mammogram Timing Could Affect Pain Levels, Study Finds

Women Say Mammogram Pain a Concern

Early Detection Can Save Lives, Experts Say

What Is a Mammogram?

What Are the Different Types of Mammograms?

What Is Digital Mammography?

Online Resources

What Is a Mammogram?

A mammogram is an X-ray examination of the breast. It is used to detect and diagnose breast disease in women who either have breast problems such as a lump, pain, or nipple discharge, as well as for women who have no breast complaints.

Mammography cannot prove that an abnormal area is cancer, but if it raises a significant suspicion of cancer, tissue will be removed for a biopsy. Tissue may be removed by needle or open surgical biopsy and examined under a microscope to determine if it is cancer.

Mammography has been used for about 30 years, and in the past 15 years technical advancements have greatly improved both the technique and results.

Today, dedicated equipment, used only for breast X-rays, produce studies that are high in quality but low in radiation dose. Radiation risks are considered to be negligible.

Always consult your physician for more information.

What Are the Different Types of Mammograms?

According to the National Cancer Institute:

A screening mammogram is an X-ray of the breast used to detect breast changes in women who have no signs of breast cancer. It usually involves two X-rays of each breast. Using a mammogram, it is possible to detect a tumor that cannot be felt.

A diagnostic mammogram is an X-ray of the breast used to diagnose unusual breast changes, such as: a lump, pain, nipple thickening or discharge, or a change in breast size or shape.

A diagnostic mammogram is also used to evaluate abnormalities detected on a screening mammogram. It is a basic medical tool and is appropriate in the workup of breast changes, regardless of a woman's age.

Always consult your physician for more information.

What Is Digital Mammography?

In 2000, the US Food and Drug Administration (FDA) approved the first full-field digital mammography system for breast cancer screening.

Digital mammography uses X-rays to produce a three-dimensional (3D)computer image. As a new technology, digital mammography is still evolving, but shows promise of more accurate screening and diagnosis.

Currently, a digital mammography machine is much more costly than a film-screen mammography machine. However, many believe digital mammography will one day replace film-screen mammography.

Always consult your physician for more information.