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Most Women Say Mammography Only Mildly Painful, Report Wake Forest University Baptist Medical Center Researchers

WINSTON-SALEM, N.C. – Fear of pain shouldn’t keep women from getting screening mammograms, according to new research data. Women who were interviewed after mammography reported only mild pain, less intense than pain from a mild headache or shoes that are a little too tight, report researchers from Wake Forest University Baptist Medical Center in the current issue of Archives of Internal Medicine.

“Physicians and patients have reported that concerns about pain are a major barrier for women getting screening mammograms,” said Penny Sharp, Ed.D., associate professor of family medicine and the study’s lead researcher. “Our study suggests that the actual pain experienced is relatively low. In fact, the level of pain would not deter 94 percent of the women from returning for mammography screening.”

For the study, 200 women were interviewed immediately after getting a mammogram.

Almost three out of four (72 percent) reported pain. The average intensity was 4 on a scale of 0 to 10, with 0 being “no pain at all,” 5 being “about average, for example a mild headache or shoes that are a little too tight” and 10 being “the worst pain you’ve ever felt.”

“Mammography is an important tool for breast cancer screening, so removing any barriers to women receiving these tests is important,” said Sharp. “Women who are particularly concerned about potential pain may benefit from learning about these study results.”

The researchers found that levels of pain were not associated with age, race, education, breast size, body mass index, or presence of other medical problems. In fact, even women who reported that they are sensitive to pain did not report higher pain levels than other women.

The study also found that the consumption of caffeine did not affect pain levels.

“A common recommendation for women concerned about pain is to cut back on caffeine for several days before the procedure,” said Rita I. Freimanis, M.D., associate professor of radiology. “We found no correlation between the amount of caffeine consumed and reported pain and we no longer recommend that women avoid caffeine before a mammogram.”

For premenopausal women, there was a link between timing of their mammograms and pain. Women whose last menstrual period occurred within eight to 14 days of the mammogram reported significantly more pain.

Women were asked what bothered them the most about having the mammogram and said that the most stressful part was “waiting for the results,” followed by “actually having the mammogram.”

“During the waiting period, a way to reduce the stress could be to educate women that only five cases of cancer are diagnosed for every 1,000 women who have screening mammograms,” said Freimanis.

Freimanis said that 5 percent to 10 percent of women who are screened are called back for further testing. About 15 percent of those will have a biopsy, and about one-third of biopsy results reveal cancer.

Breast cancer is the leading cancer in women, with more than 250,000 new cases reported in 2002. It is the second-leading cause of cancer death in women. The five-year survival rate for localized breast cancer is 96 percent, pointing out the importance of early detection through mammography and other means.

The researchers also included Robert Michielutte, Ph.D., Louise Cunningham, M.P.H., John Spangler, M.D., M.P.H., and Virginia Burnette, B.S., all from Wake Forest University Baptist Medical Center.

The study was funded by the National Cancer Institute.

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Contact: Barbara Hahn, (336) 716-6877, bhahn@wfubmc.edu or Karen Richardson, (336) 716-4453, krchrdsn@wfubmc.edu

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