OK, I recently turned 35 and my OBGYN suggested that I start getting annual mammograms (I'm starting a bit earlier than most because my aunt is a BC survivor). I was (like many other women) quite nervous about having the procedure done. But alas, a few weeks ago I did it and I thought I'd share my experience with you and give a few pointers to help you get the most out of getting a mammogram.
Setting up the appointment
Know when to start
The general guidelines for most women are that they should start getting annual mammograms starting sometime between age 40 to 45 but 5 years before you start annual screenings, you should get a "baseline" mammogram for the screening mammograms to be compared to. However, if you had a first degree relative who had breast cancer, you should start screening earlier. Specifically, you should start screening when you are 10 years younger than your first degree relative was when they were diagnosed.
Get a 3-D mammogram
One thing to remember is that not all mammograms are of the same quality. The variety that is most capable of detecting breast cancer is the 3-D mammogram. This technology takes about 15 x-rays at the breast at slightly different angles allowing a computer to determine where in the breast an object in the film is. This creates a 3-D image that a radiologist can "scroll through" when looking for abnormalities. This makes it way easier to identify an object in the film as a potential problem. Also don't be afraid of the radiation; the mammogram delivers the radiation that you would naturally receive over the course of 7 weeks of day to day life.
Schedule it the week after your period
As your probably aware, squeezing is involved in getting a mammogram so it is best to schedule the mammogram for the week after your period when your breasts are less tender. Also, because they won't be swollen, your breasts can be pressed down flatter for a clearer image and the inflammation involved won't cover any cancers on the mammogram itself.
Check your breasts the night before
It's important that the facility doing the mammogram has the most up to date information so it's a good idea to do a breast self exam the night before so if anything looks suspicious, the technologist can take note of it.
The day of the exam
Dress appropriately
OK, first and foremost, don't wear any deodorant or talcum powders because there can show up on the mammogram as abnormalities. Second, you will have to undress from the waist up so unless you wanna have the procedure done in your panties, wear a two piece outfit. Third, if you have long hair it's best to tie it back so it doesn't end up getting in the way of positioning. Lastly, it can be hard to balance when they take some of the views, so it would be best not to wear high heels.
The paperwork
When you get to the facility, you will be given a form to fill out that will ask you for general information, family history of breast or ovarian cancer, whether or not you have implants as well as any changes to your breast that you noticed lately. This is again why it's important to check your breasts the night before.
The tech will explain everything
It's perfectly understandable to be nervous but to put your mind at ease, the technologist will explain what the procedure will entail along with why some of the more "unpleasant" aspects are necessary.
Leave your modesty at the door
OK, I'll be the first to say that being topless in front of a stranger is pretty embarrassing, let alone her handling the girls. But then pressing an intimate part of your body in a machine seems downright intrusive. But remember, the ladies who do this are professionals. If you're insecure about something, keep in mind that they've handled hundreds of pairs every weak and they come in all shapes and sizes. So don't fret and to make it easier, they come with a good sense of humor.
"Prepping your breasts" for the exam
Just after I took my shirt and bra off, the tech said "OK, before we get started I'm going to prepare your breasts for the procedure". She walked over to the wall and got a pair of pink stickers with metal BBs in the middle and then put them on my nipples. And she didn't apply them in the way you'd think nipple stickers would be applied; she contoured them around my nipples and areola. No one told me about this part but she did explain that the little metal ball marked where the nipple was on the x-ray to act as a "reference point".
The procedure
Things are going to get really "handsy"
So, once I was prepped and good to go the technologist guided me over to the front of the machine, told me to face her and lifted my breast as high as it could go and made sure my hips were at the right angle relative to the machine (And I'm thinking OK lady, we've just met and you're already holding my boob with one hand and you've got the other on my butt). Then she lifted the lower plate until it was at the bottom of her hand while pushing me towards the stand with the other so my sternum was against the cassette. Needless to say positioning for this exam is going to get you a lot more up close and personal with the technologist and the machine.
You really need to "get into the machine"
Next, the technologist used her hands to pull as much of my breast out onto the cassette as she could and with one hand, she "pinned" it to the platform and put her other hand on my shoulder to push the skin forward. At this point my face was pretty much up against the x-ray tube. So this isn't an exam that you can just stand back and be stiff; you really need to get "intimate" with the machine.
Then comes the squeeze
Well, the technologist was kind enough to tell me when she was going to start bringing down the compression paddle. First, she brought it down continuously while moving the hand she had on by breast forward. Once her hand was out, she put her finger on the metal BB on the sticker and tapped the pedal (the pedals are controlled by paddles on the ground). Again, this felt awkward at first but she explained it was to make sure my nipple was pointing forward. To finish up the squeeze, she turned a knob on the side of the paddle with one hand an gently poked the side of my breast with another (again, explaining that she's just making sure everything's tight). Then she went into a small room, told me to hold my breath. Then there was a bit of whirring and beeping and then the plate released.
You'll get top-down and side to side views
After both breasts were squeezed from top down, the tech rotated the machine 45 degrees and had me rest my arm on the cassette while looking at the x-ray tube. She then stood beside me, lifted my arm up and pulled my breast as far forward as she could before holding it against the cassette. Then she pushed my shoulder down so my arm was on side of the cassette again and applied compression the same way as before. Next, she had me hold my free boob out of the way and left to make the exposure.
What it feels like
Why do the squeeze your breast?
OK, there's no denying it: squishing a woman's breast between two plates may seem "intrusive" to say the least but you have to remember that it is extremely important for several reasons. Remember that they're trying to image a 3-D structure on a 2-D medium so the more all of the breast tissue is spread out, the less overlap there will be. Also more pancaked the breast, the less the X-rays have to pass through, causing less scattering and a clearer image. So no matter how awkward it seems, the boob-clamping is for a very good reason.
It will be uncomfortable.
While it wasn't the most pleasant experience, I can say that the squishing didn't hurt. Now, it was definitely uncomfortable but it didn't even pinch. If I was to compare it to anything, I would say it felt most like getting my blood pressure taken. The technologist explained why it is to me very clearly. It's not that the harder they squeeze the better the image, it's how flat the breast is. Breasts, like any body tissue has a certain elasticity and once you reached the limit of that elasticity, adding more force won't make it deform any more, it will just start to strain the connective tissue causing pain. To see this, pinch a bit of skin on your forearm and squeeze it tighter. Eventually, you'll reach a point where you can't make the bit of skin any thinner and adding more force will just cause pain. The same principal applies to your breasts so they want to add pressure just until the skin becomes tight. Now breasts are more sensitive than the skin on your forearms so there will be some discomfort and you will be surprised by how flat they can get your girls but don't worry about them staying like that; they pop right back up when the paddle is released. So, the bottom line is this: the squeeze shouldn't be painful but if it's not uncomfortable, you should be worried that the images will be poor quality and something might be missed.
There are other sources of discomfort
OK, everyone worries about the squeeze but there were other unexpected sources of discomfort. The three that stood out for me were:
-The plates were cold
-There's quite a bit of tugging
-The cassette digs into your sternum a bit
-There's a lot of tension in the skin on your chest
But please don't take this as me trying to say how bad it is to discourage you from getting it because it was perfectly tolerable. I bring them up because if you come in expecting these things to happen, you don't end up tensing up when they do which brings me to the most important thing to getting the most out of your mammogram.
Relax, Relax, Relax
If you worry too much about a mammogram hurting, it can become a self fulfilling prophecy. When you worry, it causes the muscles in your chest area to tense up which ends up which puts more tensions on the coopers' ligaments in the breast. If you relax, the chest muscles won't be pulling back on the breast which would cause additional discomfort. Also, if you are tense, you can "jump" when the machine starts whirring, ruining the picture and requiring a re-take. But more importantly, if you relax the technologist can get more breast tissue on the cassette to be viewed (and if an abnormality is present, it can be detected sooner). So when you get your mammogram, relax like your life depends on it; BECAUSE IT DOES!!!
After the Exam
Thank your technologist
OK, remember the technologists have a stressful job. Many of the women who they see are anxious about the possibility of having cancer and aren't too fond of having their boobies smushed and when you're doing this all day, it can really rub off on you. And not only that, remember that when the technologist has your breast in your hand, she also has your life in her hand and if she messes up the image, a cancer can be missed leading to a pre-mature death. Just think about how much pressure is on them and I think it's safe to say that you would only chose a career like that if you wanted to help people. And through all that they can maintain a professional and friendly demeanor. So once all the images are taken, make sure you say thanks and give her a hug to show your appreciation <3 .
Don't let the stickers sneak up on you
After all the images were taken, I was about to put my bra back on but then I realized that the stickers were still attached to my nipples. I simultaneously pulled them off and just as said to myself "wow that wasn't bad at all", I shouted 'ouch!!!'. Lesson learned: next time schedule my mammogram at a time I can take a hot shower right afterwards.
Treat yourself
OK, you just did something really important for your health. Go grab a treat or go shopping to decompress afterward. I went for a hike with my daughter.
Don't be afraid if you get a callback
Alright, if you get a call back it can be discerning but try not to panic. Statistically speaking, 1 in 10 women called back don't have cancer. Sometimes it may be that parts of the image were blurry or some tissue was omitted. If they found something suspicious, it can be something like a cyst or an artifact on the image. If you get called back, you'll likely get a diagnostic mammogram, a breast ultrasound or MRI. Also, if you have dense breasts, that means that you have a lot of glandular versus fatty tissue in your breasts and the x-rays don't go through as well so they might want to get a better look if it was your first time.
Tell a friend or family member to get her mammies grammed.
OK, now that you've experienced it, encourage or remind a friend or family member to get a mammogram if necessary. If they're apprehensive talk to them about your experience; mention that while it is no means a pleasant experience it is so worth the peace of mind. To be supportive of each other, you can schedule an appointment together. And you never, know that mammogram might find a cancer early and save your friends' life.
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