I had my first mammogram today. The American Cancer Society recommends that all women over 20 perform monthly self-exams, and those 20-39 have clinical breast exams every 3 years; clinical breast exams by a healthcare professional should be performed annually after age 40. Mammograms are recommended yearly for women over 40. I’ll be thirty eight tomorrow, but there is some history of breast cancer in my family, so I thought it would be a good idea to get a baseline.

Not everyone recommends mammograms, even just for screening or to get a baseline, for women under 40. This site has more information on potential benefits and risks: http://mammography.ucsf.edu/inform/index.cfm . I’m writing this to describe what the experience was like, because I think a lot of women are worried about the pain and/or discomfort involved in the procedure.

It did NOT hurt.

I’ll begin at the beginning: Three months ago I told my gynecologist that two of my cousins had been diagnosed with breast cancer in the last year, and that I wanted to get a mammogram. She wrote up the request, and I called the Women’s Health Center to make an appointment. The earliest appointment was three months away.

The paper I had been given which contained directions to the Health Center contained a short questionnaire and instructed me not to wear any deodorant, powders or creams the day of the mammogram. I was to arrive 10-20 minutes early for my appointment to take care of paperwork.

The Women’s Health Center in my community is a fairly new facility, and nicely appointed. Lots of lavender and purple accents, brick red and sage green wall paper, pretty pictures on the walls. The receptionist greeted me promptly and I didn’t have long to wait before a staff member took me into her office to get basic insurance information. I was given a comment card on which to record my satisfaction (or lack thereof) with my visit, as soon as it was concluded. I was shown back into the waiting room, where there was a tabletop version of the Chartres labyrinth. I didn’t have time to trace my way all the way through it (and back out) before I was shown to a dressing room. I was asked to disrobe to the waist, and given a pink cotton cape to drape around my shoulders. There were moist towelettes available for those who had not followed directions and had used toiletry items that morning, and also deodorant wipes for suiting up afterward.

The dressing room I was in was off the hallway, with a door opposite the one I came in, leading to the mammography room. Two or three dressing rooms fed into the same “imaging department”, which must cut down on waiting time during rush hours. The technician, a nice lady who coincidentally shared my name, knocked on the door, introduced herself, ushered me into the room, and walked me through the whole process.

I had been asked on the form whether I had ever taken any hormones, and without even reading the list of brand names I checked no. The technologist asked whether I had taken birth control, which I hadn’t read closely enough to realize was on the list. She asked me to open my cape and explained that she would put markers (little adhesive strips with what looked like bbs) on each nipple. “Everyone gets pasties,” she joked. She also examined my breasts and armpits for moles, and marked them with Band-Aid-like strips with open rings where the gauze would be, circling the moles. That way, when the x-ray film is read, it will be clear that these were on the surface of my breasts, and not abnormal tissue inside the breasts. None of this was uncomfortable—not that it’s pleasant to have a stranger touching your private bits, but the room was warm and she was very matter-of-fact. I’m more uncomfortable in the dentist’s chair.

The machine itself consisted of a black platform about a foot square on which the breast rests, and a clear plastic section which comes down and compresses the breast. The technician raised the black platform to the correct height, and helped me lift and position my breast. Perhaps this procedure might have been more uncomfortable if I had less breast tissue to move around, but as it was, it wasn’t bad. I was positioned leaning forward, arm upraised, and as much breast as was possible was gently pulled onto the imaging platform. Everyone I’ve ever talked to about mammograms have winced and grimaced and complained about how painful they are, so I was prepared to suffer. * I had pictured being uncomfortably squeezed, tightly squeezed. On the way to the medical center that afternoon I had been thinking about how if it was testicles that were being examined, SOMEBODY would have found a less painful way to do it than to put them in a vice. It wasn’t like that; it wasn’t like a vice at all.** I mean, it's not the most attractive look for breasts, to be flattened like that, but it didn't hurt. For one thing, the nipples are not squeezed, so that helps.

The technician took four x-rays, one of each breast from the top down, and one on each side with the machine turned sideways, so that the platform was under my armpit and the clear top section was between my breasts, pressed against my sternum. Sort of like this: |0| . For those second two pictures, the technician had me hold the breast not being photographed out of the way, which was a slightly awkward sensation, but again, it didn’t last long.

Unlike getting x-rays in the dentist's office, where they put the plates in your mouth and then leave the room, the technician only walked a few feet away, behind a clear barrier, where she consulted a computer screen and activated the exposure. Photographs of all these steps (complete with bare boobies) are available at http://www.imaginis.com/breasthealth/mammography_imaging.asp . I was wearing the little pink cape throughout the process, but what with all the repositioning, it didn’t do much to keep me covered.

Before I left the imaging room, the technician talked to me about the likelihood of my being called back, for any number of reasons—the films not being clear, the need for additional films, etc. She told me that it was fairly common to be called back, especially the first time, and asked me to try not to panic if that happened. Results would be sent to my doctor within ten days, and that I would also receive a (more abbreviated) copy of the results. I’m sure I would be feeling very differently if I had wanted the mammogram done because I had a specific concern, but since I have no reason to worry, none of this experience was traumatic. I got dressed, filled out the satisfaction rating card, and went on with my day.

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Thanks to anthropod for mentioning the links in hir mammography writeup. I wish I had looked here, and there, before I went--I wouldn't have been so worried.

* The little booklet I was given, A Guide to Breast Health Care , says only approximately half of the women who get mammograms complain of discomfort. I wish I had known THAT before I went, too.

**Update: Just talked to my sister, who just had her first mammogram. She says a vice is the word she would use to describe the machine, and it did hurt. The technician told her women with smaller breasts often find the procedure more painful. Not that that cheered my sister up any, but it does make sense.

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