Mammogram column sparked scolding, praise

The Baltimore Sun

Recently, I wrote that the number of women ages 50 to 64 who were having annual mammograms was declining at a surprising rate.

I recounted a number of professional theories about why this was happening - from the decline in hormone replacement theory to the increased awareness of heart disease as the primary killer of women to uncertainty about the technology.

I also suggested that the decline - from 70 percent to 66 percent between 2000 and 2005 - might be explained more simply. Mammograms hurt.

I confessed that I had failed to keep my own appointment for my annual mammogram for just that reason.

I wrote that the prospect of getting a very sensitive part of my body pressed between two pieces of cold glass - the greater the pressure the greater the accuracy - had driven me under an afghan and in front of a soap opera.

Wow. Did I get scolded.

I heard from radiologists, who said I was uninformed and sending a dangerous message.

"I only hope you can sleep at night knowing that ... you have probably cost some women their lives," wrote one radiologist.

"I can only say shame on you," wrote another.

I heard from women who were breast cancer survivors who said that the pain of a mammogram was nothing compared with the cancer treatments that followed, but that the early detection that resulted from a mammogram had saved their lives.

I heard from others who lost sisters or friends to breast cancer. They wrote that their loved ones would trade the discomfort and humiliation I described for another chance at life.

But I also heard from one reader whose mammogram - and sonogram - failed to detect the substantial lump she had found herself during a self-exam. Only an MRI showed the tumor.

"Never again will I waste my time with a mammogram," she wrote in frustration.

One reader made the very good point that she was sure a bikini wax or a Botox injection hurt more than a mammogram, but that didn't stop women from having them.

But some women wrote to say they shared my reluctance to have a mammogram.

"Now, another year has almost past and I'm due for my annual mammogram in late July. ... I will definitely be scared, upset and anticipate the awful level of pain," wrote one reader, who had a particularly miserable previous experience.

"I keep thinking that having your breast tissue squeezed so intensely cannot be that good for your health."

One writer said she was not looking forward to having her breasts run over by the equivalent of a Mack truck.

"I am not a drinking woman - but I will have one before I get it and after it is over," she wrote.

"I totally agree," wrote one reader. "There isn't any day when I wake up and think, 'Oh yes. Today would be a great day to have a sensitive body part smashed between two plates of glass, while standing awkwardly with my arm around an X-ray machine.

"Thank you for saying it out loud."

Another reader - a mammography technologist and educator - said she, too, had been concerned about the decline in mammograms and added, "I think that the media has not mentioned the comfort issue as a reason for the decline."

I took it on the chin for this column, that's for sure.

But the most disturbing reactions were those that suggested that a mammogram was not something I should be doing for myself - it is something I should do for the family that would grieve my death from breast cancer.

I was also criticized for failing to be a role model - not just for readers of this column but for the young women in my life who would learn from my example.

I could have written that kind of column.

I could have talked up mammograms and Pap smears and colonoscopy. Teeth cleaning and regular eye exams. Cholesterol checks and skin cancer checks. I could have written about the importance of immunizing children and getting your husband's blood pressure checked.

That's what women do. We are the gatekeepers of family health, and we make all the appointments and check all the boxes. Often while neglecting our own well-being.

I have written that kind of column before. About doing the right thing. I am the Queen of Sensible Advice.

This time I was going for something different. I was going for a little candor.

The number of mammograms among women ages 50 to 64 is declining, and the medical community is mystified.

I repeated some of its explanations and then offered one of my own.

Doctor, it hurts.

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