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Liz Thornhill performs mammograms for a living.
So she's used to hearing women complain about the cancer screenings -- an X-ray taken with the breast squashed flat between two glass plates.
And though most of her own exams have been uneventful, Thornhill says, even she was taken aback by the tight grip of one memorable mammogram. The machine clamped down like a vise, pulling at the skin of not just her chest but the base of her throat, making it impossible for her to move.
"I thought, 'Oh my gosh, is this what I've done to people?'" says Thornhill, 49, a technologist at Memorial Sloan-Kettering Cancer Center's Breast Examination Center of Harlem in New York.
The discomfort of mammograms scares some women away, says Marisa Weiss, a doctor and founder of breastcancer.org. Other women simply dread the yearly exams, which are recommended for women over 40. "It's not the most inviting test," Weiss says.
Although researchers are experimenting with different ways to screen for breast cancer, there are no proven alternatives to mammograms on the horizon, says Christy Russell, chair of the American Cancer Society's breast cancer advisory group.
To Carol Lee, chair of the American College of Radiology's breast imaging commission, the tests are worth a moment of discomfort. They are one of the few screenings shown to save lives, and Lee credits them for much of the 2.3% annual decline in breast cancer deaths from 1990 to 2002, noting that many women feel no discomfort.
Some women might feel more willing to have the exams if they knew how to make them more comfortable, Weiss says.
Experts offer these ideas:
*Schedule your exam when breasts are less sensitive -- after your period but before ovulation, or between days 5 and 10 of your menstrual cycle, Thornhill says.
*Take two or three pain reliever pills, such as ibuprofen, an hour or two before your mammogram, Weiss says. Check with your doctor about which drug is best for you.
*Ask the technologist to adjust the machine to your height, Thornhill says.
*Avoid caffeine, which may make breasts more sensitive, for one week before the procedure, Thornhill says.
*Relax and lean into the machine. Hunching shoulders will pull skin away from the plate, increasing discomfort, Thornhill says.
*Ask your doctor to recommend a facility that does many procedures, Weiss says. Experienced centers may do a better job and require fewer repeat tests.
*If
you have a good experience with one technologist, schedule future tests with the same person, says Carolyn Kaelin, a doctor and author of Living Through Breast Cancer.
*Warn the technologist if you have extremely sensitive breasts, Weiss says. It's all right to speak up if the discomfort is unbearable. If possible, though, doctors urge women to put up with the pain. The tighter the compression, they say, the clearer the result.
Thornhill has no second thoughts when scheduling her own mammograms. As she sees it, "going to the dentist is worse."
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