Why can't we squash pain of mammogram?
HEALTHY-SENIORS (September 22, 2010)
The root canal was painless, thanks to my dental surgeon, who asked numerous questions, expressed great concern about my comfort and, on his own initiative, applied a topical numbing agent to blunt the discomfort of the actual shot of local anesthesia.
That's right: I got a pain reliever for my pain reliever.
I was the same person, presumably with the same pain threshold, when I showed up for my mammogram, but you wouldn't have known it from the behavior of the technician, who, with barely an apology, proceeded to compress a very sensitive part of my body in ways that were pretty much guaranteed to be uncomfortable.
My mammogram hurt as much as a pinch or a slap. It didn't hurt on the level of a twisted ankle or a finger jammed in a car door, but why did it have to hurt at all?
Mammogram pain affects somewhere between 1 percent and 62 percent of women screened, but medical studies on how to reduce it are few and far between.
I asked the author and researcher Susan Love what the current pain-reduction options are, and she e-mailed me back, saying there is no magic bullet. Letting the woman control the compression helps, but the images of the breast aren't always as good, she wrote. Padding on the machine can reduce the discomfort, but also impede the image in 2 percent of women.
Studies suggest that over-the-counter pain relievers such as Tylenol and Advil are not effective.
Magnetic resonance imaging is more comfortable for women than mammograms, but it's not preferred for routine screenings, in part because of a tendency to produce false positives.
One of the few bright spots I could find was a 2008 study published in Radiology, in which researchers at St. Luke's Mountain States Tumor Institute in Boise, Idaho, managed to cobble together a solution using the topical over-the-counter pain relief gel Topicaine and plastic wrap (to cover the gel after application).
Women got significant pain relief from this approach — about 20 percent, or equivalent to a reduction from 5 to 4 on a 10-point pain scale, according to Colleen Lambertz, a nurse practitioner who co-authored the study.
But the pain relief was only partial, and the FDA recently warned of rare but potentially fatal side effects when drugs such as Topicaine are used on large areas of skin. Lambertz has conducted a follow-up safety study but she declined to disclose the results prior to its publication.
When I asked Lambertz why there hasn't been more research on mammogram pain relief, she laughed:
"The only answer I can come up with is, I'm just not sure we were listening to women enough."