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Sunday, July 12, 2009

What to Expect at a Mammogram

A sigh of relief--the mammogram came back clear.

Two weeks ago, I found a lump in my right breast after 20+ years of problem-free self-breast exams. For two weeks, I walked around, my fingers rubbing the lump, trying not to Google anything about breast cancer. Do you know what it felt like? You know how when you're home alone and you hear a noise, you pause from movement, holding your breath, waiting to hear it again so you can identify it as a normal house creak or a warning that a serial killer is about to break in through your kitchen window? You want to breath and move, but you're worried that if you move, the sound will come again at that very moment and it will be lost amongst the other noises such as the rustle of the blanket or the intake of breath.

That's how I felt for two weeks.

I really didn't want to talk about it because talking about it made my hand return to my breast and I had already spent enough time walking around the house alone, my fingers palpitating it. I had driven around Washington, D.C. with my hand inside my shirt (oh please don't look in my car--I swear I'm not a perv, just a nervous woman with a lump in her breast). The night before the mammogram, I had lifted my t-shirt to mark my breast again with a Sharpie and at that moment, my telephone rang showing my neighbour's name on the caller ID. I dropped my shirt and stared in horror at the window, certain that he was calling to gently inform me that the whole neighbourhood is horrified by the amount of time I spend copping a feel these days.

Except that he was calling because he wanted me to take care of some house stuff while he was away.

I am writing out these details in case they are helpful to someone else who is in the same position of waiting for a mammogram. Please add your own advice or experience at the bottom of the post, especially if I leave out anything because every mammogram is different. It's sort of a non-IF Operation Heads Up.

The first thing to know is that there are two types of mammograms: diagnostic or screening. Most people have a screening mammogram which means that a series of images are taken, they are read by someone later on, and you receive a report in the mail. Diagnostic mammograms need to be scheduled at special times and the difference is that additional images will be taken of the site of the lump and a doctor will read it immediately so they can follow up with additional tests while you are in the office. My mammogram included a follow up ultrasound.

On the day of the mammogram, do not wear deodorant, lotions, or powders near your chest. The reason is that these things smudge the plates and not only transfer to the machine, but also can blur the image. The place I went had spray deodorant in the bathroom, though I threw my deodorant in my purse the night before so that (1) I could use it afterwards and (2) I didn't forget and accidentally put it on in the morning.

The other thing to know is to not wear a dress. Wear pants or a skirt because you will only be undressing from the waist up and you will be sitting--most likely--in the cover-up top they provide in a group waiting room.

Also, when I signed in, my office offered to send me a copy of my report if I filled out a sheet stating where I wanted it sent. If your office doesn't automatically do this, make sure you ask for a copy of the report to be sent to you at this point and then remind the technician or doctor during the appointment too. I have to imagine all offices would be willing to send you a copy so you have it for your own medical files, but my office was particularly proactive, offering it before being asked.

My mother came with me, sending an email a day or two beforehand informing me that she would be doing this. She knows me well enough to know that I was internally flipping the fuck out even though I said I was fine going alone. She came with me when they called me back from the main waiting room to the smaller waiting room. The man who came with his wife was asked to remain in the main waiting room. In other words, the space was ladies only. They brought us to a smaller waiting room and asked us to change into the cover-up, leaving our bras and tops in a locker. And then we waited to be called back.

The mammogram is done standing up. You put on a lead apron around your waist. You stand before this huge machine that has a part that looks like a glass shelf. The technician places your breast on the shelf (relax your body as much as possible and don't try to help her) after adjusting the height of the shelf and then a top plate of glass comes down, compressing the breast like a...boob sandwich with glass bread. A thick boob sandwich with a lot of filling because while I thought the machine would smoosh them down so hard that they would look like Wile E. Coyote's hands after the Roadrunner runs them over with a car. You know what I'm talking about? When he has to peel them from the pavement? So...no...the mammogram doesn't compress your boobs like that. It's...well...

My mammogram sort of felt like a teenage boy who doesn't know quite what to do with your breasts. He's just so freakin' excited to finally be able to tell his friends that he has touched a pair of mammary glands that he is both shitting himself and pushing your boobs at the same time.

You probably won't be surprised to hear this, but the mammogram, like most tests involving the body, is described on a widely sliding scale of pain from mild discomfort to holy shit and the thing to keep in mind is that the pain factor varies greatly from breast type to breast type (do you have dense tissue or a lot of fatty tissue), life experience (nothing has ever been as painful for me as my HSG--it will forever be my "10" on a scale of 1--10), skill of the technician, tensing of the surrounding muscle, and whether or not you took a painkiller beforehand.

I did opt to take two Alleve an hour before the exam therefore, take it with a grain of salt when I tell you that it was only mildly uncomfortable. I proactively took a painkiller so who knows what it would have felt like if I hadn't come prepared. I also concentrated on relaxing my shoulders and back. So, some people will probably say that it was very painful and some will say that it was nothing at all because each person will experience it differently.

She set up the machine and compressed the breast and then ran over to take the image. She then pushed a button from where she was standing and the machine released the breast before she walked over. So all in all, the breast was compressed for under 30 seconds each time. It took a minute or two to set up each picture and get the breast where it should be. So the actual discomfort time was quick.

She took two image (one of each breast), pressing down from the top. Then, she turned the machine and took two additional images (one of each breast) pressing in from the sides. Again, it was just mildly uncomfortable (think panting teenage boy). Then she had to take additional images of the lump area because I was having a diagnostic mammogram, even though it was also serving as my baseline, age 35 mammogram.

She gave me a small sticker with a metal dot on it and asked me to place it over the lump. Then she switched the top plate on the mammogram to a smaller plate and took one more image of that small area. That was the only compression that actually hurt. And on a pain scale, I'd place it around a 4. Not something I'd like to endure for hours, but not terrible for the thirty seconds the breast is compressed. She removed the sticker and I returned to the waiting room.

A short time later, I was brought back for an ultrasound of the breast. It is exactly like any other ultrasound (well, except the transvaginal ones)--goo on the breast and then the paddle moves around while the technican examines the screen. A doctor then came in to give the all-clear. She could feel the lump, but said that it didn't feel worrisome to her and the mammogram and ultrasound both came back with the tissue looking normal with no additional growths or cysts in that area. She told me to keep an eye on it and to alert my doctor if anything changed. As long as there were no changes to the lump, I could wait to have my next regularly scheduled mammogram.

I asked her if I could get a copy of my films (this was in addition to the report that will be sent to me in a few weeks) and then waited in the main waiting room for an additional half hour to walk out of the office with them. It's worth waiting in the office and walking out with the films so that you have them for your file.

Again, my PSA--I know that I stopped focusing on self-breast exams and pap smears during treatments, assuming that since an RE was up in my ladybits that problems would be found automatically. But this just isn't the case: you still need to do your yearly pap smear and monthly breast exams. Leave a note for yourself on your calendar, hang one of those water-proof reminders in your shower, but do it. And if you feel anything suspicious, be proactive and ask a doctor instead of worrying that it's all in your head. PSA over.

So that was my first mammogram experience. Add your own notes in the comment section on your mammogram experience. This post will be linked to from the left sidebar under Operation Heads Up for anyone who wants to use it in the future.

43 comments:

Rebecca said...

I am so glad that it came back clear. Thanks for the PSA. (((HUGS))) to you for what I know is a stressful wait. I found my lump about 8 years ago and remember the agony of waiting. I had a needle biopsy done on mine and thankfully it is only a hormonal cyst. It comes and goes with the turning of the monthly tides, which my doctor says is perfectly normal.

Again, so glad that everything is clear with your girly parts...now you can stop feeling yourself up on the highway and scaring your neighbors! :)

Tash said...

Oh phew. What a relief.

Two additional points: at my baseline screen, the tissue folded over itself when they compressed and made the picture hard to read. This apparently happens a lot, and is not unusual no matter the size of your breasts (I can't believe my small ones can fold over anything). Because you leave the office and someone reads them later, you will be called back in to retake your films should this happen -- don't be alarmed if they tell you this is why. They're not kidding.

Point of the second: my shit-ass private insurance (we're self-employed) while they covered the original, balked at paying the follow up even though it was technically the fault of the imaging center and they ordered the repeat. It was a long back/forth before it got sorted out.

Phew again.

My Reality said...

So glad for the all clear.

Paz said...

Great news!

My first mammogram was a breeze. It was pre-baby and I had firm, dense breasts. Post baby, they were more soft and the mammogram was not so pleasant. Tolerable certainly, uncomfortable and yukky but not truly painful.

My mammogram was made better when the technician was concerned about what issue has caused my doc to recommend having one done 'so young.' Ha. So Young? Do you think she says that when she sees that certain look in the eyes? Like fear.

Thanks for the PSA.

Anonymous said...

My mother died from breast cancer so I am a big supporter of mammograms. I do want to warn others about the pain--not to scare you off from getting one but to prepare yourself. As Mel said, the pain can vary from person to person, technician to technician.

My technician said it wouldn't hurt much. I really wish she had said it would hurt like hell because then I would have been better prepared. I have small, very small boobs, and trying to squish them was horrendous. I have a high pain tolerance, and this was unbearable. The only reason I go back is because of my mother's cancer. I've had two mammograms, and neither was less painful, even with painkillers in advance. My sister-in-law who is also quite flat chested passed out after her recent mammogram.

So if you're going for your first mammogram and you have small bubbies (tm the Real Housewives in New Jersey), take something in advance--it might help--and be prepared for pain!

--Small Bubbies Unite

calliope said...

oh honey.
first off all- PHEW INFINITY!

then- to write this post...well it is just so helpful and kind and like a giant holding of the hand.

Io said...

I'm so glad your boobies are okay.
And smiling at how you it is to make this a community learning experience. You rock.

Christy said...

So glad you got the all clear on your boobs, and thanks so much for the PSA as well. You're awesome!

Vee said...

Oh that is absolutely wonderful news !
What a relief.

Great post, I will certainly be referring to it when I go for a mammogram.

Pie said...

I had my first mammogram on Thursday, and blogged about it. So feel free to go over to my blog to read my experience.

Mel, so glad to hear all is well for you!

Deathstar said...

Two years ago, I had to return for an ultrasound - I could barely sleep - but when the woman told me it was clear, I felt like I had dodged a bullet. Hubby's looking at me like of course, but I had tears of happiness. How did you feel?

When so many women get bad news, women I happen to know, I know enough to be grateful and check the girls every chance I get. Grope, grope, checking them now.

Carrie27 said...

I've been anxiously waiting to see how things panned out for you. So glad that things are in the clear.

Thank you for sharing your experience, and to the other commenters.

Michelle said...

WHEW I am so glad that everything came back all clear. This also reminds me that I need to schedule my first mammogram. Thank you for this info I did not know what to expect and now I do!

Kymberli said...

Thank goodness everything came back clear. I've been worried about it. Your post has served as a good reminder for me. For one, I don't always remember to do my monthly breast exams, and secondly, I didn't realize that at age 31, I was so close to the point of needing to start yearly mammograms.

areyoukiddingme said...

Glad it came back with good news. I got the order for a mammogram at my last yearly check-up. I haven't done it yet. Not looking forward to it, and when I go for this year's check-up at the end of the month, I'm sure my doctor will berate me for not going. Sigh. I guess I'll have to go this year...

Fran said...

Oh Mel, delighted it was all clear!! I have no advise to add as I never got one done (only ultrasounds, apparently if your tissue is too dense they are not very useful) but probably will get one done at 35 (very soon then!)

Lyrehca said...

Glad to hear the mammo came back negative. By the way (I'll send you a separate email), I *just* finished reading your book this afternoon. It's terrific!

Sunny said...

That's good news -- WONDERFUL NEWS! I am so relieved for you. No more public indecency, now, please. :) I think it's great that you are putting this out there so the rest of us with hooters are prepared!

Helene said...

I'm so glad that you got good results! And thank you so much for posting exactly how the procedure goes from start to finish. I need to start going for mammograms as of this year, esp because breast cancer runs in our family. My mom had me all freaked out saying how painful it is. It's a necessarily evil I suppose!

Erin said...

Oh Mel, thank goodness everything is OK. I have a friend who survived stage 3 breast cancer at age 27 and have become fanatical about doing exams, because that's how she found the lump that led to her diagnosis. I'm glad you put this PSA together, since we'll all have to get a mammogram at some point.

And again, I'm so glad that you're OK!

loribeth said...

Nothing I can think of to add to your tips -- just so glad all is well!!

VintageMommy said...

I've been checking your blog every day waiting for news . . . so glad the news is good, Mel, really.

angie said...

What awesome news!

Ellen K. said...

Very glad that all is OK!

Chickenpig said...

This is all great information, but I need to add, not only women get breast cancer! The FATHER of a good friend of mine is fighting breast cancer right now, and men are more likely to die of it than women. More and more men are contracting breast cancer, possibly from hormones in meat or whatever. I don't think they recommend mammograms for men, ever, but make sure you..ahem...feel up your man's chest for lumps every once in a while and have them looked at if there are any changes or fluid secreted.

Very relieved over here that your lump was a false alarm.

Ms. C said...

So glad to hear that everything is all clear. What a relief!
Thanks for the detailed description. You are a superstar to share it all with us.

Shelby said...

Glad to hear it was all clear!

My first baseline mammogram was about 2 years ago at age 30, due to family history of breast cancer and cysts. Thankfully it wasn't too bad, and I didn't even think to take anything beforehand. I have heard that if you are well endowed, it doesn't hurt as much as if you are flatter, because there is less pulling to get the breast between the plates. Overall I'd say a 2 on the scale of 1-10. Just mild discomfort for me. Glad I did it though. And now, in a month, I get to have my first colonoscopy. Joy of joys.

Jendeis said...

I'm so glad that it came back with an all-clear. :)

Billy said...

Glad mammogram came out clear! Hurray for that big relief!!

cowboyboot lady said...

I am so glad your results were good. I have been thinking about you and hoping for the best! I will definitely be less forgetful in doing my monthly exams.

Cibele said...

I was holding my breath reading your post. I am glad that it is all clear

haus said...

I had a benign lump removed when I was 25 or 26 -- so no matter how young you are, DO THE SELF-EXAM.

heyLyss09 said...

SO glad you're A-ok!

Great info! Seems like many women don't know really anything about mammograms until they actually need one.

Bea said...

Holy crap, Mel! This is what I'm missing! I'm so sorry you had to go through the experience at all - it must have been very worrying. But very glad it's all clear, as most lumps in women your age do tend to be, I'm told - which is reassuring until you're the actual patient. Bit like being an IVF patient in that sense.

Anyway, I'm glad you got the all-clear, and thanks for this informative breakdown on what it's like. Good reminder to keep checking at the end, too.

Bea

Flying Monkeys said...

I was lucky that they read my films while I was there so I didn't have to leave and get the call back, my stomach still dropped when they said they needed to repeat the film to verify. I didn't take any pain relievers and it wasn't as bad as I expected. I've done worse to have babies.
My aunt just died from breast cancer that metastasized into her bones. Her doctors dropped the ball, one actually moved out of the country without notification and she wasn't given complete instructions just an all clear when it was still cloudy. A second aunt was diagnosed 2 months ago. I have fibrocystic breasts, PCOS and I'm a fattie...the math is there but I still stink at self exams.
I'm glad you got the all clear!!

Kristin said...

I'm so glad you are ok.

Lisa said...

I am so glad to read that everything was clear!! What a relief it must have been!

Jodi said...

Wonderful news that all is clear.

Thank you for posting your visit in full detail so us mammogram "virgins" know what to expect.

I lost a friend to breast cancer last year ~ she was 35. Cancer sucks. Self exams are so important so who cares if neighbors and people in traffic see you doing so!!!!

nic88 said...

As a Radiologic Technologist that used to do mammograms I read your experience with great interest (and am so glad that your results came back negative!). It is refreshing to hear someone's take on having a mammogram besides the usual complaining. No one would willingly like to have their boobs crushed in a cold hard device so I appreciate you sharing your experience. Hopefully more women will not put having a mammogram off!

Thanks,
Nicole

Photogrl said...

Yay for the all clear!

As always, thank you for being you and explaining your experience.

becomingwhole said...

I'm so glad that everything came back clear. Thank you so much for posting about this. I'm not so good about remembering about the self-exams, and this is an excellent reminder, as others have said. Your transparency helps us all so much, Mel. Thank you so much.

LisaN said...

Thank you so much. I have a lump and am having a mammo/ultrasound tomorrow morning. Currently flipping & Googling & pre-crying and happened upon your blog. I feel so much better, such a mitzvah!

Lyn said...

Belated congratulations on your clear mammogram. Karen might have already mentioned this to you - I told her how helpful your post was to me when I went to have a mammogram. I am under 40, but had to get it done before the fertility clinic would begin treatment because of "significant family history." The history is that my mother died a year ago of breast cancer. Since I didn't have her there to share her experience, it was especially important that someone (you) reached out as one woman to all of us. I also want to thank the people who commented with their own experiences. All of it helped me get through it. My mammogram came back clear, so I'm hoping to get the show on the road soon. Keep being awesome.