To wonder why there is no effective alternative to Mammography?

[Charliesunnysky10]

3 years ago, when I was 48, I was delighted to be asked early for a routine mammogram (I had no pain or lumps). I have dense breasts, and the pain during compression was excruciating. I don't even know if the radiographer managed to complete it, because I went faint. I've had pain in my right breast ever since, which I took to be bruising/strain, but when it didn't go I was referred for investigation at the hospital breast unit June 2021. They did ultrasound which was clear as far 'as they could see' but 'mammogram is the gold standard and only that will tell us for certain'. I had to be content with the ultrasound as my fear of the mammogram pain got the better of me. Fast forward to last Sept, I went on combined HRT and have what I took to be hormonal pain in both breasts which masked the targeted pain in my right. However it's coming through more than ever now and I've been referred back to the hospital for the same process as 18 months ago. Part of me is so angry at myself of being fearful of something that could save my life, and the other part is worried sick about how I will cope even with painkillers if I can get over the fear, and wondering why this is the only scan that still compresses tissue; why in over 100 years there is no effective 3D alternative.

I know when I had the mammogram when I had broken rib that the other two women waiting to see the same person as me both said they were very nervous and reluctant to have the mammogram. I assumed she was a specialist in dealing with people who were nervous/found it particularly painful/ or had some other issue. Might be worth anyone asking who finds it particularly difficult.

@adultingforever That's really interesting. I fear that so many healthcare decisions are made because of profit & politics. But I'm glad the tumour was detected.

There are also harms with screening as is clearly laid out in the NHS leaflet and by Cancer Research Uk.

Cos all the decisions are made by men and it's a woman's health issue.

Things like women's comfort and dignity aren't high priorities in health care.

For evidence see every damning report on maternity services written in the past twenty years.

@Meseekslookatme That's so bloody awful. I honestly think it's like something out of the dark ages, this idea that we give birth so can handle anything.

I remember being shocked how painful it was and when I mentioned it when I got back to work and how violated I felt, people looked at me as if I was making it up. I've just worked out it will be three years since my last one in September, that's something to look forward to.

There are probably potentially countless far more effective ways of screening… but in all likelihood they will never materialise because so few people bother to research and develop improvements in female-centred medicine… because nobody bothers funding and investing in R&D for female centred medicine. Because it’s female centred.

I too find mammograms incredibly painful, my breasts are fairly small and not dense at all. The last one left me with bruising near my armpits on both sides. I’m 6 months overdue for my 3rd and am considering paying for a scan instead.
Nobody else I’ve spoken to has found it more than a bit ‘uncomfortable’ - I felt like I was going to faint/vomit with the pain.

I forgot to add that the tumour I had to have removed was found by me, doing an old-fashioned self-exam. Drs. were soooo surprised.

I had a referral from my last standard mammogram, and then went for a 3D one at the breast clinic. It was so much better. Then they did an ultrasound. They found nothing and suspected a "crease" in the original mammogram. Now this could have been the operator, but I had also had an expert for troublesome boobs at the initial mammogram, as the one a few years earlier had ripped the skin under one of my boobs and made it bleed!

I think some women, like me, with large dense boobs, really can suffer 😥

Yep.

Absolutely.

Same with iron supplements. If men frequently ended up needing to take iron supplements, an alternative to the tablets (which cause such severe constipation, stomach cramps, upset stomach etc that many women simply give up on them) would have been developed.

I've only had 2 mammograms - the first one was completely pain free and comfortable and I'll admit to wondering why other women complained about them 😳. However, the 2nd time the height or angle or something wasn't quite right and it was very painful - I felt like I was suspended by my breast! I do think it's maybe a matter of technique and positioning, and some are better at it than others in the same way some people are much better at injections/taking blood.

Me too, fortunately it eased off after a week but was so sore!

Apparently the position of the machine can make a difference - if it is really painful it might be worth asking them to consider whether the machine is too high (or low? I think it is high but am not sure).

@SheWoreYellow Thank you. All these suggestions are so helpful and very gratefully received.

A combo of Thermography and ultrasound is a good alternative although you would have to pay privately for that (ive had several on harley street and also involves no radiation). Thermography can pick up potential risks years before a mammogram. However, if there was any concern they'd then ask you to have a mammo as it wont give a full picture of any concerns.

I don't go for smears and I won't go for mammograms.

They should invite all 50+ women to classes to teach self breast exam. That's how most breast cancers are detected.

I relate so much. I had a very painful one at 47, I'd had a cyst. There's no way I could go through that again. I do do self examinations. I bring myself to do smears. I feel like just staying healthy and warding off early warning signs is so unendurable.

Ultrasound or even MRI isn't any BETTER than a mammogram, it just uses different technology as a way to look at your breasts. It's not used as a screening tool as it is only as good as the operator using the machine, is difficult to replicate images and can miss very small lesions as breast tissue isn't easy to look at.

Ultrasound cannot detect early signs of cancer (DCIS) but a mammogram can, hence why it is gold standard. Its true there are mammographically occult lesions but I'll be honest, these are on the rare side. Also it is quick to do, quick to report and is cheap. All good reasons it is good for screening.

This. I’ve had mammograms that were a bit uncomfortable and some that hurt. My last one was absolutely fine.

I've had 3D mammograms in the US, as well as follow up ultrasounds, and a MRI.

The mammograms were a tight squeeze, no doubt about it, especially with dense breast tissue. But it wasn't so bad that I made a note to self to take something ahead of time for pain next time round.

It sounds as if you had a poorly trained technician and could have suffered an injury to a muscle. Have you considered getting a physiotherapist to take a look?

I have had 5 mammograms, which includes an extra one as I had a 2 week referral for a concerning symptom. I have also been told that I have dense breast tissue. Only one of the 5 mammograms was very painful. All the others ranged from mildly uncomfortable to entirely painless.

Yes, the painful one was very painful, and my breasts ached for a long time afterwards, with transient pain for months, but it was just one. The memory of pain does make you flinch and hesitate to expose yourself to pain. It's certainly very real. But it doesn't predict that it will happen the same again.

There are 2 reasons why they have to compress the breast. The 1st is to reduce radiationdose, the second is to improve tissue contrast. I did an essay on this at uni and Ultrasound shows great promise but not quite as sensitive.

I am so sorry you had a bad time.
I have had one mammogram and it was absolutely fine. It might be okay with someone more gentle? The nurse I had was very gentle. You could ring up to talk to them about it beforehand.

As someone else has already explained mammograms are currently the best detection method. And MRIs can be pretty awful for some people.