February 14th, 2011
08:40 AM ET

How can I make my mammogram hurt less?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Mondays, it's pediatrician Dr. Jennifer Shu.

Question asked by Paula of San Diego, California:

I had my first mammogram yesterday and my breasts are still really sore. I am fairly small-chested, and the tech said that usually makes it hurt more. What can I do for the pain now, and is there anything I can do to make it hurt less next time?

Expert answer:

Thanks for writing. I definitely feel your pain! In fact, it has been reported that over 60% of women complain of severe pain during the mammogram procedure itself. However, fortunately, the pain usually subsides within 10 minutes of completion of the study.

Because of the compression that takes place during a mammogram, some women continue to be sore for a few days or longer. This may especially be the case when multiple images need to be repeated. Even if there's no visible bruising on the skin, the tissue may have been damaged enough to cause ongoing pain. For current pain, you may find relief from over-the-counter pain medicines or using a cold pack (such as an ice pack or a bag of frozen vegetables wrapped in a thin towel) applied periodically to your chest.

Some physicians recommend taking oral acetaminophen or ibuprofen about an hour before a mammogram to help reduce the pain, but studies have not proven this practice to be effective. I don't see a downside to trying though, as long as you don't have an allergy or sensitivity to the medication.

There has also been a report that using an over-the-counter 4% lidocaine gel product on the skin may be more effective than oral pain relievers. Other solutions may include letting the patient control the application of the compression or using a thin pad or cushion around the breast. These last techniques may cause the images to be of poorer quality, thereby potentially being inaccurate or requiring repeated X-rays.

Next time you're scheduled for a mammogram, you may want to talk to your doctor about the latest pain control options available. Good luck!

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  2. Ann

    I have good and maybe helpful information to share (information that I haven’t found anywhere else yet online, and I wish I had). And I have suggestions after I describe my tale of woe that may help the fearful and anxiety-ridden individual move forward.

    After years of pain-free mammograms at a state-of-the-art mammography center at a well-known and well-respected Boston hospital with compassionate technicians, I had an experience that really shook me up about a week ago. I was on the first of six images to be taken. The technician couldn’t get me situated on the plate that well (I’m small breasted). She compressed me, compressed further and then quickly compressed me further than that to a point that seemed insane. I felt like my breast had been slammed in a door. I had sharp, radiating knife-like pain. I felt like I was going to pass out from it. And because pain on other parts of the body is usually an indication of something is wrong, I was certain something was wrong. I was in a panic. My technician that day surprisingly brushed off that pain and my concern. She told me that what I was experiencing was called “uncomfortable.” I told her through gritted teeth as I was waiting for her to be done with that image that it was not the correct word for what I was feeling at that moment. After the next five images (those not painful), she told me I’d have results in the mail in about six to eight weeks (a much lengthier time than I remember—which I still think is a bit cruel), and she added that if something was wrong, I’d get a call back. I left there feeling anxious, shaky and sick to my stomach.

    A few days later, I got a call back asking me to return for a repeat mammogram on that breast that had the sharp pain (it still felt bruised from the ordeal). I was assured that everything was fine so far and there was nothing to worry about, but there was one image that wasn’t good enough for them—not clear enough. They told me there would be a radiologist at my appointment to look over the image (no two month wait). That call sent me into anxiety overload with sleepless nights, not able to work all that well, sick stomach (essentially the mind took over the body—I’m hardwired—it’s my personality). My mind can take me places I don’t want to go when life dishes me something unsavory. It’s just me, and I don’t like that about me. So here I was last week, unsure if I could get through the pain of a repeat mammogram, feeling silly about that like I was being a baby. (Heck, there are people that go through far worse than that—I know this, and I have gone through far worse too.) So I began researching online for anything that might help me get through this situation, and there wasn’t enough info to allay my fears or give me an answer on why I felt such intense pain that day.

    So here’s what I learned from my repeat mammogram and a compassionate technician at that same Boston hospital, who explained why I experienced such pain. And I will tell you what I did to get myself to that appointment.

    1. If a technician compresses your breasts too fast, the technician on the repeat mammogram told me that it’s typical to feel horrible pain—it’s what happens. Technicians are taught to be gentle and compress the breast ever so gradually. It is “uncomfortable” as in the situation feels awkward and there is tightness from the compression, but it should be manageable.

    2. If you have had pain in the past, tell the technician from the outset that you are “compression sensitive.” I was told that you should always alert them to the fact that you have had a bad experience in the past, so they will be extra gentle with you. In fact, alert them to any fears you have about it. They are supposed to listen to you.

    3. Even armed with this knowledge I just gave you, you may still experience anxiety. I was armed with the above information only “at the time of the repeat,” so I didn’t know any of this before the repeat mammogram. I think it is a good idea to call your primary care physician and have a chat. I did that. I told her about the horrendous pain and my fears and my anxiety. She suggested taking a few ibuprofens an hour before the procedure (your doctor may suggest something else for your type body). She said it may help and it may not. She said that in my case, I could always forgo the repeat mammogram if I wanted. She had the images in her hands as she was talking with me on the phone and said there wasn’t any hint of cancer. They just needed a better image. Hearing this from her and having an out helped a bit. She said each mammogram is a different experience and that I should always plan for the worst and maybe it wouldn’t be so bad. She also said she could talk with the mammography center about my pain concerns for the repeat, or I could do that myself with the technician (either way she assured me that they would listen to her as much as they would listen to me). I decided that I would talk to them, and if I got the brush off again like I did at the previous appointment, it would be my red flag to ask for a different technician (and I’d ask it in a nice way). I decided that I would take my health and comfort into my own hands (and of course that made me a bit anxious too … who wants to be in a confrontation?).

    So back to the ibuprofens. I am a migraine sufferer and ibuprofen for my head pain has never worked too well. Instead, I carry my prescription medicine for migraine headaches wherever I go. I decided that my prescription drug would be my drug of choice for the day of the procedure. If I wasn’t getting a ride to the appointment, I would have chosen the ibuprofens. Operating a car on migraine medication is not a good idea—do not do it! Be safe! The medication I use is a combination of a barbiturate and an acetaminophen. The bottle indicates I can take one or two pills at the onset of a headache. I took two an hour and a half before the repeat mammogram. The barbiturate in that pill curbed the anxiety: Let’s be honest, I was high; floating on air instead of a jumbo wave of sickness. It helped! My suggestion: get a friend or loved one to drive you to the appointment. Ask your doctor for something for the anxiety and something you can use for potential pain, should there be any, which there shouldn’t.

    So the repeat appointment for me went very well: no anxiety thanks to the pills, no pain thanks to the technician (I don’t think I needed the pain pills), and no problems thanks to good fortune. And the next time I have this done, I’ll skip the migraine medication and just talk with the technician beforehand to let her know that I am “compression sensitive.”

    I hope this helps someone out there. I have never felt a need to comment on an article before.

    Best wishes, good luck, and good health to anyone who reads this.

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