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Making mammograms a gentler experience


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Getting a mammogram, what with the pinching, the pulling, the pressure and leaning into a cold, metal machine with half your clothes off, isn't something most women mark in their calendars with a little happy face.

In fact, a Duke University study shows half of women describe moderate to extreme discomfort during mammograms -- pain that scares some away from getting the procedure, a key step in detecting breast cancer.

With that in mind, hospitals and clinics are taking extra steps to make the process a little more comfortable -- soft foam, warming pads and lots of gentle care.

Women don't need much of an excuse to avoid mammograms, which are recommended annually if they're older than 40, said Becky Ingram, a mammography technologist at Winchester's Clark Regional Medical Center in Kentucky.

"Sometimes it takes just one person to tell another woman a painful story."

"(Some women) make it sound like it is the worst possible thing that you will ever go through," said mammography technician Elizabeth Thatcher. She's heard it compared to extremes as slamming a breast in a freezer door.

But she said that in the 15 years she's been seeing patients, "I have yet to have a patient coming in for her first mammogram and walk out of the room saying 'This is every bit as bad as I thought it would be.' "

Now Clark Regional and other mammogram centers, including some Western New York care centers, are using a relatively new product that women report does make the test more comfortable. It's called a MammoPad -- a thin, foamlike rectangle sticks to the tray placed underneath the breast. It costs about $5 and generally isn't covered by insurance, but Clark covers the cost to encourage women to get their exams.

MammoPads have been used by Spectrum Radiology Associates of Williamsville, which does 600 mammograms monthly, for two years.

"The salesperson said we were the first to use them locally," said John Cornell, administrative director.

Initially, the manufacturer supplied the MammoPads free to introduce them to patients. "When we surveyed patients, about half said it didn't matter or change they way they felt, and the other half loved them," said Cornell. "Not every woman cares about it. If they haven't had a problem, they don't really want it."

When the practice started charging $5 per use, Cornell said that 47 percent of patients opted to use the MammoPads.

"I know some women are very tender and this helps soften the compression required to get good images," he said. "It also takes the cold shock away when the patient is placed on the machine.

"What we've found extremely helpful, though it wasn't the original intent, is that it holds the breast deeper into the image receptor, allowing us to get more tissue on the film. We'd all like to make it a standard of care, but the problem is that reimbursement for mammograms is so low, that you just can't afford to do it."

Cornell said they had one patient bring in a MammoPad, a year later, that had been used for her previous exam.

"She must have loved it," he said. "We don't know how she got out with it, but she stored it for a year. We had to tell her they aren't reusable."

Windsong Radiology, also of Williamsville, did a trial with about 100 patients about 11/2 years ago, said Nicole Crawford, marketing specialist, but found that patients weren't willing to pay the extra cost.

"When we surveyed patients, they said it was more comfortable," said Crawford, "but the insurance doesn't reimburse for it and that's an issue. The patients said they wouldn't be willing to pay for it, so Windsong chose not to move forward with it."

Both Buffalo General Hospital and Millard Fillmore Hospital use MammoPads, said Dawn Taylor, Suburban's manager of cardio-pulmonary and imaging services.

"Everyone is given these pads free of charge," said Taylor. "We just decided it's good for the patients. First of all, 50 percent of the patients say it's much more comfortable, but 100 percent say it's warmer. They used to complain about the tray being cold, but the pad is warm to the touch, so it immediately has a warming effect and there isn't the cold shock."

Taylor said medical personnel like the fact that the product has been approved by the American College of Radiology because it doesn't interfere with getting a good image.

"At first I thought this isn't going to make a difference," said Cindy Brookshire, who used the pad in Kentucky. "But it took away the coldness, it reduced the amount of pinching."

The pad also allows the technician to increase compression of the breast, resulting in a better image, she said. Regular compression is between 20 and 28 pounds. With the pad the average is 38 pounds. That turned out to be an added bonus for Brookshire, who at 42 has been getting regular mammograms for seven years. Her doctors said the additional compression helped detect early-stage breast cancer.

"They were able to get a better view," she said.

She's planning on a lumpectomy, and possibly a precautionary round of radiation. She's optimistic about the outcome, and is determined to encourage others to get tested.

She has a friend who is "scared to death to go back. I tell her, 'Just because you've had one bad experience it doesn't mean you will have another bad experience.' "

News Staff Reporter Paula Voell contributed to this report.

(C) 2005 Buffalo News. via ProQuest Information and Learning Company; All Rights Reserved

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