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.

Yes, the painful one was very painful, and my breasts ached for a long time afterwards, with transient pain for months

This does not sound good at all, no one should suffer breast injury from screening, it’s barbaric.

Trauma to the breast can cause injury to the breast tissue and bleeding, which can form into a palpable mass. Bleeding can result in a hematoma, a collection of blood in the breast from the disruption of a blood vessel. On a mammogram, this area of injury will eventually be represented by calcifications. Hematomas eventually get reabsorbed by your lymphatic system.

Self exam used to be promoted and there were leaflets teaching you how to do it. It is no longer recommended as the negatives i.e. unnecessary treatment and side effects from that, outweigh the positives. Instead we are supposed to be breast aware. So not a formal examination, just be aware what your breasts normally look like and feel like.

@Aphrathestorm

The detection of very small, stage 1 cancers is far better accomplished by routine mammograms, especially 3D mammograms, in women with average risk (a 12% lifetime risk).

Very early detection gives a better chance of cure.

In women with a first degree relative who has had breast cancer or if there's a known or suspected genetic risk, routine breast self exam is recommended, and not considered optional, by the American Cancer Society.

Funding of research into breast cancer in the US far outstrips research in other cancers.

I've always dreaded mammograms as I've always found them painful and thought that my breasts would burst.
Went for a routine mammogram last autumn . Was dreading it but immediately noticed the machine was much smaller than previously.
I slapped me bap out onto the plate and waited for the crushing pain. None whatsoever.

I mentioned how different and more comfortable it was and the nurse said that they'd got a new machine that also offer better imaging. She said that this new machine was becoming the preferred one for screening purposes.
Maybe these are more widespread now.

I've had a few mammograms now, and none of them were remotely painful - slightly uncomfortable at worst. Maybe I'm just lucky, or had sympathetic and skilled staff but although I really wasn't looking forward to the first one, I found it extremely quick and honestly not painful at all. It's not what I would call a pleasant experience, having boobs squished between metal plates, but on a scale of 1-10 I'd rate it a 1.5.

Because of the patriarchy.

Mammograms pick up small microcalcifications which can be associated with DCIS (early non invasive cancer) which ultrasound can't.
Ultrasound can pick up small masses in dense breasts that mammogram can't.
In symptomatic clinic both are used, for screening mammogram is most effective.
It's rubbish you had so much pain in your last mammogram!

“I doubt men would agree to have their testicles crushed every couple of years.”

Too right @milkyaqua . If this had ever been proposed as a screen for testicular health issues, it would have been rejected as being too painful for a diagnostic procedure.

Probably because it only affects women so it’s not important enough to find a better solution or fund more expensive alternatives. If men had to have their knob squished every few years to check for cancer you can guarantee there’d have been a painless way of checking invented decades ago.

Interesting. I find a few of the procedures they do to women poor, and can't understand why there isn't better alternatives.

As @StopGo states"..... Crushing delicate breast tissue seems draconian."

It certainly is.

Yes both tests have purpose, that’s maybe why both should be offered? As I said I pay for ultrasound and am happy to do so, not everyone might be able to do that.

I’ve had one mammogram and found it very painful, pain and tenderness for over a week afterwards too.
That was years ago. I’ll never have another. Hoping my years of breast feeding and clear family history protect me.

The point of screening is to pick up early cancers, most of which are occult on ultrasound and picked up by microcalcifications on mammogram.

Maybe that is why I had no pain at all? It was honestly no big deal at all.

YANBU I'm afraid this is why at 55 I have never had one - I have very large dense breasts and I just can't face it even though I gave a high pain threshold. There is also a school if thought that the compression causes trauma to the breast which is in itself harmful, plus there's a high rate of false positives. I'm thinking of going private and requesting only ultrasound and just taking the risk - possibly better than nothing at all??

I was diagnosed with breast cancer 3 years ago (first symptom was breast pain) so have had more than my fair share of mammograms. Part of the planning treatment was a breast MRI which was hideous.
I now have annual mammograms. My take on this is that technicians vary a lot. Some grumpy ones who are a bit rough and others who are lovely and kind.

I have a lot of BC friends and all of us plan to pay privately for annual checks once the five years is up. Sometimes ultrasound picks up something a mammogram misses. The radiologists know exactly what they are looking for though.

Yes I hoped that. Fully BF'd two children. Never took HRT in case of risk of breast cancer. Still got me.
The biggest single risk factor for BC is age, something no-one can avoid. All the other risk factors are insignificantly small in comparison.

I have had two the first very painful, second barely any pain so it is possible.

I've had two and neither hurt. Uncomfortable yes, but not painful.

My last mamo was quite painless , but as a radiographer I think the more compression the better the image .

When my mammograms showed things theyvwanted to check, they then did an ultrasound.

Maybe ask for an US instead?

Thank you. It’s not 100% better after two years. I think I’ll be due another mammogram at the end of this year, which is a worry.

All I will say is that I’m grateful that my mammogram picked up my microcalcifications that was actually DCIS when I was 42. I had a mastectomy so next time I’ll just have to have the remaining boob squeezed until I get that one removed as well.

Everyone must make their own decisions on this, just please ensure it’s an informed one. I wouldn’t wish the last six months I’ve just had on anyone!

@lurchermummy Im bigger too. HH cup. Really dismayed to see how painful this procedure is.