Letters / Correspondance

Breast pain causes noncompliance with mammography and self-examination

Canadian Medical Association Journal 1996; 155: 632-633

Dr. Heather Bryant examines the reasons for noncompliance with mammography in her article "How should we interpret noncompliance with screening mammography?" (CMAJ 1996; 154: 1353-5 [full text / résumé]). How about the possibility that noncompliance results from deliberate consideration of the trade-offs, particularly for women like me whose breasts are often intensely painful? I have had mammography many times in my life, and the mammograms have usually revealed lumps, many of which have been removed and all of which have been benign. I am at a low risk of breast cancer in terms of heredity, diet and various other factors. On nearly every occasion when my breasts were squeezed into the machine's large clamps, it hurt like hell. When my husband asked what the pain was like and I tried to find an analogy, I could find nothing closer than the feeling that the whole breast is like a boil. Therefore, when I am told to have a mammogram, I usually wait a few years.

Furthermore, physicians seldom, if ever, recognize that pain in breasts is a major problem interfering with breast self-examination. When I try to examine my breasts, my brain cannot receive the stimuli from my fingertips because of the intense pain at the site I am trying to examine. My present family physician understands this. In the past, other physicians have said something like, "Yes, but it's the best method we have." Yikes!

Nancy Porter-Steele, PhD, MFCC, TSTA
Halifax, NS

| CMAJ September 15, 1996 (vol 155, no 6) |