My First Mammogram

By Shannon Hicks

Fewer words bring more fear to the hearts of women than breast cancer.

And even fewer bring on thoughts of discomfort than mammogram.

But by submitting to the latter, we may alleviate the former. This kind of preventive maintenance is as important as changing the oil in our cars every 3,000 miles.

Breast cancer occurs when a malignant tumor develops from cells of the breast. A malignant tumor, according to the American Cancer Society (ACS), is a group of cancer cells that may invade surrounding tissues and/or spread (metastasize) to other areas of the body. Breast cancer is exponentially more common in women, although it has been known to occur in men.

The chance of developing invasive breast cancer at some time in a woman’s life is about one in seven.

In its guide What Are The Key Statistics of Breast Cancer? (revised in January) the ACS offers this: “Breast cancer is the most common cancer among women, except for non-melanoma skin cancers.

“It is estimated that in 2005 about 211,240 new cases of invasive breast cancer will be diagnosed among women in the United States. At this time there are slightly over 2 million women living in the US who have been diagnosed with and treated for breast cancer.”

The bad news continues: “Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer. The chance that breast cancer will be responsible for a woman’s death is about one in 33 (3%)

“In 2005, about 40,410 women and 460 men will die from breast cancer in the United States.”

There is some good news, however. The ACS says death rates from breast cancer have been declining, and that the decreases are believed to be the result of earlier detection and improved treatment.

Mammograms are the first instrument of defense against breast cancer. Mammography is an X-ray test of the breasts, or mammary glands, used to screen for breast problems, especially lumps; the X-ray itself is the mammogram.

Mammograms are done to screen for or diagnose breast cancer. Screenings are done to make sure a woman’s breasts continue to be clear of lumps or suspicious tissue.

Small tumors can be seen on a mammogram long before they can be felt by a woman doing a self-breast exam or even her medical professional.

Mammograms also help diagnose breast cancer if a woman begins showing symptoms (a lump of thickening in the breast, nipple discharge, or dimpling of the skin in a small area of a breast). When an abnormality is found, a mammogram will help locate the area of suspicious breast tissue for a biopsy — the removal of some of the suspicious breast tissue for examination under a microscope.

I went through my first mammogram earlier this year. My personal physician had scheduled a full physical for mid-January, and at the end of that she suggested I go for the baseline mammogram.

I can’t say that I hesitated in saying OK. My maternal grandmother went through a mastectomy when I was in middle school, so the fear of breast cancer has always been in the back of my mind. I still remember the night my mother sat my sister and me down to tell us the news that Grandma was going to have an operation because she had breast cancer. Grandma. Cancer. My sister and I couldn’t stop crying, we were so scared.

Having turned 35 last year, I knew it was time to start thinking about mammography.

My appointment was at the Southbury office of Housatonic Valley Radiological Associates. Try to remember not to use any deodorant, perfume, powders or, ointments on or near your breasts on the day of a mammography test, I was told.

Most likely, the office where you are having your mammography test done will mention this when they call to confirm your appointment. The reason they don’t want women wearing these substances is the residue left on our skin by these things can actually interfere with the X-rays.

I made a point of taking a very early appointment because I didn’t want to go all day without deodorant. I noticed some wipes in the office where I had my test done, however, and when asked about them the X-ray technician told me they keep them on hand for those who forget to not put on deodorant, etc, as well as for those who have appointments later in the day and cannot go that long without our balms and creams.

Another thing to remember: Try to schedule your test for two weeks after your period (but no longer than three weeks). For one thing, your body will best accept the discomfort of the mammography test at that time of the month.

Secondly, and medically important, fibrocystic changes can cause breast swelling and pain, and often happens just before a period is about to begin.

 Most breast lumps are not cancerous; they are benign. Most lumps, say countless ACS documents, turn out to be fibrocystic changes.

 “Fibrocystic refers to fibrosis and cysts,” says one ACS memo. “Fibrosis is the formation of fibrous (or scar-like) tissue, and cysts are fluid-filled sacs. … Your breasts may feel nodular, or lumpy, and, sometimes, you may notice a clear or slightly cloudy nipple discharge.” Those “slight lumps” are enough to give most women a sinking feeling; remember, however, my earlier statement — most lumps are benign. They are perfectly normal. They are nothing to lose sleep over.

At HVRA the morning of my mammography test, I was first asked to fill out the standard paperwork, provide proof of insurance, the usual.

I walked into the mammography room and met the lady who would be running the mammography. She told me to get undressed down to my waist, to put on a paper vest that had been laid out for me, and that she would come back into the room in a few minutes.

Then it got personal. I know it’s her job to position a woman’s breasts for the best possible reading, but it’s unusual from my end to have a woman handling my bosoms.

It isn’t a sexual thing, either; it’s just business. And by the time I got used to that idea, it was time for the mammography machine to start compressing my breast.

Wow! Now I really appreciate what my mother was talking about all those times she said it was time “to go get my boobs squished.”

The medical professionals prefer to use the word “compression,” and that’s the right word for it.

Two large plates pressed my right breast as flat as possible, to just over the comfort line, and held me in place like this for a few seconds while the mammogram was being shot.

Being tall, it also meant I needed to bend my knees a bit for each test. So there I am, attached to a large machine with my breast between two plates, knees bent, and trying to stand still long enough for an X-ray to be shot. It was all uncomfortable, but not painful.

“Are you comfortable dear?” the technician said, with a smile. She knows how difficult it is to have a mammography test done, but she tries to make the best of it for every one of her patients. She and the receptionist both knew this was my first mammography test — my baseline, from which all future tests will be compared — and they were both nice enough to talk me through every step of the appointment. It helped that they were both female, of course, but it also helped that they allayed any fears of the machine and the procedure.

Then it was time for the second test on the right breast — the side view. This was even more interesting than the first test because this time it meant having my breast squeezed from the sides, still while slightly bending my knees and holding my breath in order to stay still.

And then it was time for everything to be repeated on the left side.

A mammography test should not take more than 20 minutes, but I promise you it feels like it is much longer than that.

In January, the X-ray tech told me not to worry if I received a notice in the mail that a second test would be required.

“Very often, especially with the baseline tests, we shoot two tests because we want to make sure we have a clear view of what your breasts and tissue look like,” she told me. “If something looks abnormal, or even if you moved enough to create a blurry image, we like to take a second set of tests to make sure everything is clear.”

The good news came about a week later. Tests came out clear. The form letter had the best option checked off: No evidence of breast cancer.

My next suggested visit to a radiology lab is not expected until 2010.