"Like making a panini with your boobs," is how Annemarie Crabtree, of Spring Hill, Tennessee, describes getting a mammogram.
And with good reason. Although mammograms are critically important for screening for breast cancer the experience can be far from delightful. It involves placing one breast at a time on a machine that clamps it between two plates while a low-dose X-ray of the breast is taken.
"The point is to stabilize the breast to hold it still and get it as thin as possible so that a clear picture is possible," explains Susan Brown, senior director of education with Susan G. Komen. X-rays don't go through tissue very easily — hence the need to flatten the breast so as to spread out the tissue. This allows for a better X-ray image with less radiation.
Currently, mammograms are the best breast cancer screening tool at our disposal. But could there be other ways of getting the same results with no pressure on the boobs?
Breast ultrasounds are sometimes done, where a handheld device is moved over the breast to take pictures of it. It's used to check abnormal results for a mammogram (for instance to see what's inside a breast lump.) "It's more comfortable [than a mammogram], but it isn't accurate enough with the limitations in processes and technology required now to be a screening tool," Brown says. "But it could one day be an option or even better than a mammography for screening."
Until the day when a simple cheek swab does the trick (how awesome would that be?!), enterprising researchers are developing some other options. The Thomas Jefferson National Accelerator Facility (Jefferson Lab), in conjunction with Dilon Diagnostics, developed breast-specific gamma imaging, which uses the Dilon Camera for a more decisive picture.
"The patient is actually injected with a chemical which would be more likely to be absorbed by cancerous tissue," says Drew Weisenberger, Ph.D., the leader of the radiation detector and imaging group at Jefferson Lab. Once absorbed, any cancerous cells would "light up," allowing the scientists to form a two-dimensional image. In terms of comfort, it's a far more pleasant experience. "The Dilon Camera confines the breast to make it easier to image, but they don't have to do the compression," he says.
The Dilon Camera and associated processes aren't on the market yet for this purpose, however. Partly, this is because the injected radiation is a higher dose than patients currently are exposed to during a regular mammogram. Researchers are working to reduce that dose to comparable levels, however, so that it could one day be a viable preventative screening option.
Weisenberger points out that images provided by the Dilon Camera are far clearer than current mammograms. Often, women are referred for biopsy for concerns that typically wind up being benign. "This technology definitely has value with regard to possibly reducing the number of biopsies you have to do," he says. "Biopsy is not a trivial thing."
The process of lowering the radiation dose could take a while, though. Currently, they're testing on "phantoms" that simulate the tumor-to-background ratio. "Trouble is if you go [with] too low a dose you won't get the results you want; you won't find the cancers you're looking for," he says of the delicate balancing act.
Until then, take comfort in the fact that current mammography equipment has already come quite a long way. Now, the compression paddle releases immediately after the image is taken, whereas before the technologist had to walk back over and manually disengage it. And there are some ways you can lessen your discomfort with your current mammogram.
- If you're premenopausal, schedule your mammograms immediately after your period when your breasts are less tender.
- Use over-the-counter pain medications or even breathing techniques (like those during in childbirth) to help with anxiety.
- Talk to your mammography technician if you're feeling a lot of discomfort during the procedure.
- Keep in mind that any breast pressure is worth it in the short and long term. "Most of the women I saw in the imaging center I used to work at left saying, 'Oh this isn't nearly as bad as I thought it was going to be,'" Brown says. "It's not exactly something fun, but you do it. It's the prudent thing you do for your health."