#mammography

I had a few concerning symptoms a while ago and ended up getting a mammogram to check them out. My mother had emphasized over and over throughout my childhood how badly mammograms sucked, so I was nervous. Like, trembling in the waiting area nervous.

Since then, I've spoken with friends who are my age (early 30s), and they all said they were also terrified of getting a mammogram when the time came. My experience may not be universal, but I thought I would share how mine went in case it encourages someone else to get important care or helps them feel less nervous.

This is a mammogram machine:

The mammogram tech lowers the bottom table-ish surface (plate) to chest height, then helps you place one breast on the surface. The top plate lowers until it compresses your breast. It stays there for a moment while the tech takes images of the breast. You may be asked to hold your breath at certain moments so they can get a clear image.

(I want to say here that the compression is firm, but for me, it did not hurt, or pinch, or sting, or any of the unpleasant adjectives I've heard older people use. A lot of that probably depends on how sensitive your breasts are, but the mammogram tech reminded me to tell her if something was too uncomfortable.)

The top plate lifts, then they tilt the plates into a diagonal angle. The top plate lowers again, this time compressing your breast at an angle. More pictures.

The same thing happens with your other breast. That was literally it.

Like I said, this was one mammogram experience and it was the only one I've ever had. I'd be interested to hear how they go for other people, but frankly, I'd go through a lot worse not to die of breast cancer like so many others in my family have. This wasn't a fun or entirely pleasant experience, but not the horrible, painful, aching mess I had been led to believe it would be.

Finally, if you're someone who has had mammograms (especially if you are speaking around younger people, including your kids), please be mindful of how you talk about the experience. I cannot emphasize enough how pants-shittingly terrified my friends and I all were because we had heard the horror stories from our parents. You don't want to be the reason someone puts off important preventative care.

I'm not kidding.

i've seen this post making the rounds and y'all: all the problems we have with ai art and women's body parts as the image pool expands? those don't magically stop being a problem when the images are x-rays of the fingers and noses instead of fantasy drawings. there's a reason they started with hackneyed crap.

marketing is as marketing does, they sold you on stuff you'd recognize, so they'd know what to say when they came back to sell you a second time.

and none of this is even bothering with the racial disparities in diagnosis and treatment. the models are trained on existing samples, when blacks and natives are laughably underrepresented in the medical lit, guess what the "ai" will have a harder time diagnosing.

Breast Case Scenario

Breast cancer is the most common cancer in the UK, accounting for 15% of all new cancer cases. If breast cancer is spotted earlier, then the patient’s chances of survival dramatically increase. Mammograms are a well-known way that medics can detect and measure breast density and spot any cancers that may be starting to form. But this analysis is done manually so it can be misinterpreted, different doctors may have varying opinions, it's time consuming and the poor image quality makes small changes difficult to spot with the naked eye. In order to try and make critical diagnoses earlier, researchers applied a machine learning model to analyse mammography images to improve the detection and classification of benign (left) and malignant breast tumours (right), which the model did with incredible accuracy. It was a promising performance that helps the clinician with speedy diagnosis, treatment planning, and follow-up of disease progression.

Written by Sophie Arthur

Image from work by Tariq Mahmood and colleagues

Faculty of Information Technology, Beijing University of Technology, Beijing, China and Division of Science and Technology, Department of Information Sciences, University of Education, Lahore, Pakistan

Image originally published with a Creative Commons Attribution 4.0 International (CC BY 4.0)

Published in PLOS ONE, January 2022

I’m sharing because this happened to me this week, and I didn’t know what to expect, and I’m hoping it can help someone.

My PCP found a lump on Monday which concerned her, plus it was tender to touch. I haven’t been doing monthly exams mostly because I don’t know how and because I’ve had so much going on. No more of that!

Every clinic handles this differently but I went specifically to a breast cancer clinic. I didn’t see a single cis man, which I mention only because I was naked. TERFS, go to hell and DNI.

The intake paperwork included the date of my last period and said if it was greater than 10 days I would need a belly apron. I wrote on the sheet that I was celibate and no one questioned it. It saved me the embarrassment of having to talk about it to a stranger so that may help someone. Just wanted to include this as an FYI for people with uteruses.

After doing intake paperwork I was brought back by my mammography technician. She explained my three outcomes for today’s visit:

No significant findings — no follow up requires

Return for repeat maging in 3-6 months

Schedule a biopsy within the next 7-10 days

Although my sister came with me, she waited in the waiting room. I’m not sure she could have come back with me, had I been super anxious, because COVID, but it’s worth asking.

It was her job to answer questions and she was super patient about it. We were in a private consult room for this which was great.

She then sent into a changing room to change out of my bra and top and put on a hospital gown with the opening facing front. I washed the deodorant from my armpits because that can affect the results, and also removed my jewelry. They recommend no lotions, body glitter, deoderant, etc. I left my purse and pretty much everything except my phone in the locker. Then I waited in a private waiting room with a few other women next to our lockers. I think they even heated the gowns for us?

After just a few minutes my tech took me back to to mammography room. My machine looked like this:

She asked if I knew where the lump was and marked it with a piece of clear medical tape. The bumpy kind so be aware of that texture although I’m sure that varies. She explained every step before we started. If you tech does not do this, ask them to. Also ask them to prompt or explain each step as they do it.

I opened half my gown and she gently manhandled my breast, and me, into place. It was awkward positioning but she kept asking if I was comfortable so modifications could have been made if I was in pain. It wasn’t comfortable, but it wasn’t like having my boob run over like I’d been told to expect? A very, very firm pressure. It was tight but I could breathe and talk. The glass plate is cold!

I was asked not to move, to breathe normally, t breathe in deeply, hold, exhale, hold. This is for I believe the vertical series. Then the machine pivots, my breast was smashed at like a 45 degree angle and, after repositioning, the horizontal series is completed.

Then we repeated this for the other breast even though there wasn’t a lump. I retied my gown, put my glasses back on, and went back to the waiting room.

The whole imaging took 5-10 minutes. Two positions each. Both breasts.

I waited maybe 15 minutes and a different tech brought me into the sonogram room. This is standard practice at this clinic — both a mammogram and an ultrasound.

I laid on my side leaned back on a wedge. It wasn’t super comfortable, but it was ok. Anyone with hip or back problems or wheelchair bound will/may need modifications.

I was alone in this dark room less than five minutes, but this is where my anxiety spiked big time. Possibly because I was prone, or because it was dark, or because I kept staring at the mammogram results which were on the screen. The doctor came in, introduced herself, and reviewed my mammography results. She explained what they showed her and walked me through the process.

I lifted my arm over my head like Rose in Titanic. Instead of being drawn by Leo though, my boob got covered in warm goop and the u/s scanner moved around the boob. It took less than five minutes. She did not do the entire boob, just the area around the tape. I think it would have been more if they had found something super concerning. My other breast did not have a sonogram.

My results were fine, I was told immediately no follow up was required but I would need to come at 40 for a regular preventative maintenance mammography.

All in all this took less than an hour, but had they been busy I could have expected it to be longer. Everyone was so kind and it was a consent based clinic.

I don’t know how much choice you would have if you ever find yourself in this position, but I wanted to share my experience because, for once, it was a good one.

Everyone introduced themselves.

The clinic was patient-centered.

Explanations and consent were given every step of the way to align my expectations with what was about to happen.

My results were clearly explained.

Every provider asked if I had questions and then paused and made eye contact and to wait for me to give a verbal response.

They did their best to preserve my dignity/modesty.

This? This is my new standard of care.