Mammograms may not need that painful ‘squish’. Should I be relieved or appalled? | Mona Gable

Its hard to believe it took this long for someone to look at whether making mammograms less painful would also make them less useful

Like most women, I dread going for my mammogram. Just the thought of having my breasts pinned between two hard plates, one hand gripping a bar overhead while a technician tries to shove them into position, is enough to make me sweat. Talk about painful. Talk about exacting a pound of flesh.

So when my doctor recently asked if I had scheduled my screening, I was tempted to lie and skip the torture altogether. But I didnt, because I have dense breasts and a history of breast cancer in my family, two factors that put me at higher risk. And because the alternative is obviously worse.

But the lesser of two evils mentality is a pretty low bar when it comes to a test a majority of women are urged to take annually. And now new research from Lund University in Sweden reveals that all that squeezing and pain women go through is probably unnecessary, as the images that result dont inevitably lead to a better diagnosis.

Magnus Dustler, a doctoral student in the Department of Translational Medicine at Lund used data from 20 to 150 women to measure how pressure is distributed on the breast during mammograms. He found that when the compression was reduced by half, it had little effect on how the pressure was dispersed over the central areas of the breast, which Dustler says are the most important diagnostically.

Im thrilled that a researcher decided to look into this aspect of mammograms, and I hope his findings lead to gentler mammograms in the future. But I have to ask: no one thought of this before? Even Dustler acknowledges that researchers have shown little interest in the relationship between pressure, pain and image quality in this widespread screening tool.

Still, why did it take so long? If it were men having this medieval procedure annually, the medical profession would have taken the pain it causes far more seriously.

They would have looked more closely at the data the high rates of false-positives that require women to get a second mammogram and then wait for those results while worrying, do I have cancer or dont I? This has happened to me twice. Maybe a technology that effectively hasnt changed since the 1960s doesnt give the best results.

Still, millions of women dutifully endure the squeezing and the anxiety every year. We do it because weve been assured that it detects breast cancer early, which it does, though with a lot of caveats, like not being able to distinguish between early-stage cancers that are ultimately deadly and those that wont grow, leading to overdiagnosis and treatment more needless pain for more women.

Relatedly, many studies, including a 2012 study in the New England Journal of Medicine, show that women who had mammography screening were just as likely to die as women who didnt have mammograms. In other words, mammograms increased diagnoses and surgeries, but didnt save lives, Dr David H Newman wrote in the New York Times.

Many women dont know all this, since public health and breast cancer awareness campaigns emphasize early detection over all the subtleties. So women continue to support a mammography economy that promises them a false sense of security.

Think about how often the screening guidelines have changed in recent years. If youre a woman hitting 40, is that when you should have your first exam? Or is it 50? Is it every two years now, or one? Does it depend on your health, genetics, yoga? Im being facetious, but the point is, no wonder women are confused. And now were being told that perhaps we didnt need to endure that pain after all. Should we be relieved or furious?

My hope is that the medical profession will finally listen to women and develop a more accurate technology to diagnose breast cancer. Its only right. Its only womens lives, after all.

Read more: https://www.theguardian.com/commentisfree/2016/oct/11/mammograms-painful-breast-check-procedure-change

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