Getting My First Mammogram During Women’s History Month

Written By Brianna Halek

Breast cancer is unfortunately a part of many women’s histories. So, to close out Women’s History Month, I was inspired to write this article. I got my first mammogram on March 31st, and I thought it would be helpful to share my experience as well as more information about breast cancer that is important for everyone to know.

Cancer isn’t rare. Breast cancer is the second most common cancer (skin cancer being the most common). The American Cancer Society has reported that between 1989 and 2017, death rates from breast cancer have gone down 40%. (https://www.cancer.org/latest-news/report-breast-cancer-death-rates-down-40-percent-since-1989.html#citations) However, this decrease has mostly been seen in white women. Black women are still more likely to die from breast cancer than white women in the United States. Both black and white women are more likely to get breast cancer than women from other ethnic/racial backgrounds. Screening for breast cancer usually begins at age 40. Black women are more likely to get breast cancer before that age and they are more likely to die from it overall. The Susan G. Komen organization said that even though the one-size-fits-all cancer treatments are being replaced, “The COVID-19 pandemic also highlighted the disparity in breast cancer treatments for rural and low-income people across the country, as well as the disparity in treatment between black and white women. Black women in the U.S. are about 40% more likely to dies from breast cancer than white women". (www.komen.org/about-komen/our-impact/breast-cancer/breast-cancer-awareness-month/)
 
There are many risk factors when it comes to breast cancer. Not all risk factors can be controlled, but one that needs to be more openly spoken about is alcohol. Drinking alcohol has been shown to increase risk for many cancers, including breast cancer. One of the reasons is that alcohol raises estrogen levels. “Moderation is key. One drink per day has been shown to slightly increase the risk of breast cancer. Having more than one drink per day has shown to be a more significant risk factor, and the alcohol content doesn’t matter: wine, beer or a mixed drink”. (https://www.nationalbreastcancer.org/breast-cancer-faqs/can-drinking-alcohol-increase-the-risk-of-breast-cancer/)
 
While breast cancer education and prevention focuses on cis-females, it should be noted that it is possible in all sexes and genders. For example, although less common, men can get it as well. The American Cancer Society estimates that about 530 men will die from breast cancer in the United States in 2022. (https://www.cancer.org/cancer/breast-cancer-in-men/about/key-statistics.html)

​Not every change to the breast means cancer, but still, don’t ignore anything that’s different for you and try to become familiar with your anatomy. The National Breast Cancer Foundation says that “Though 8 out of 10 lumps are benign, all require evaluation to confirm that they are not cancerous.” If performing a breast self-exam, it is best to do it 7-10 days after their menstrual period starts. This is the time when breasts are the least tender and lumpy. If they are no longer menstruating, then they should examine themselves the same day of each month.  (https://www.nationalbreastcancer.org/breast-cancer-faqs/how-often-should-i-do-a-breast-self-exam-bse/) (*Tip: Read about the different symptoms of breast cancer at the end of this article - It’s more than just lumps)

Mammogram Image clevelandclinic.org

“Since you’re over 30 now we’ll order you a mammogram too”.

I was being seen by an APRN at a breast surgery office. I am 32 now. The last time I was in this office was a year ago to follow up on these benign tumors I have called fibroadenomas. It was not the first time I pointed out a new lump and was told, “I can’t feel it”. It’s still hard to look back at other appointments I’ve had, like when I first told someone at my regular gynecology office what I felt had changed. I experienced some dismissiveness, since they only gave me a prescription for an ultrasound because I was concerned. It’s a lesson I continue to learn, that we have to be our own best advocate. Medical appointments go by fast and one has to get practice speaking up for themselves. Including getting a second opinion. If you’re concerns aren’t taken seriously and the provider does not explain why they aren’t concerned… perhaps look elsewhere.

I asked the APRN if the mammogram would hurt and asked about radiation exposure. She said some women find it more uncomfortable than others, and that the amount of radiation is the same that one gets exposed to during a flight from New York to California. I was able to schedule the mammogram plus ultrasound just two days later, on the last day of Women’s History Month. I thought, “how fitting”. I know there must be so many women who are wondering what it is like, so I wanted to share my experience for education and awareness purposes.

I arrived 15 minutes before my scheduled appointment and after checking in and being given a wristband with my name and other info on it, I went to another waiting room. I was given a pink gown to change into. I was asked when the last time I had any type of vaccine was (they can cause a benign, temporary lump in some people that could show up on imaging). Luckily my mom told me not to use deodorant or lotion that day. It can interfere with the results, creating white areas that make it look like possible cancer. No one informed me of this when I made my appointment or during it.

​The mammography technician called my name and brought me into the room with her. I was asked a few questions, including: What age was I when I started my period, if this was my first mammogram, if it’s possible I could be pregnant, and what age was I when I had children (not applicable to me). Since it was my first one, I wish the technician would have prepared me for it more before we started. I think I should have been told or given reading material about how long it was going to take, how it might feel, and that my breasts would have to be touched by the technician to get me in the right position. Even though I can write about health and education, I recognize that often during healthcare appointments I may not think of what to ask in the moment. I can get nervous and I am also relying on the healthcare providers to inform me versus the other way around. That’s one area where communication is so not perfect in medicine, and it should be improved.

I believe I got what is called a diagnostic mammogram due to me feeling a change in my left breast. They did a mammogram on both breasts to compare them. Because of this, I was given a sticker that had a piece of metal on it and the technician said to place it over where the lump is. Right after I was placed in position between two sheets of plastic, she told me to hold my breath for each scan. It was a bit difficult for me to hold my breath, probably because I was anxious. I was hoping that wouldn’t mess up the imaging’s accuracy. The mammogram took x-rays of my breasts from two different angles and probably took a minute total. It did feel painful for me, however, it was a manageable level. Mammograms likely feel uncomfortable for most people, but they are worth it to be more informed about your health. (If you have a lot of pain during a mammogram, tell the technician as they might be able to adjust it). Women go through a lot of uncomfortable and painful testing. There isn’t always the ability to decrease this discomfort and I wish that was different. If you already know you have more sensitive breasts or perhaps if you’re having cycle-related tenderness, you can ask your doctor if it’s ok to take something like Tylenol beforehand.

I had an ultrasound afterwards. Since I have gotten breast ultrasounds in the past, I was prepared for what it’s like. Getting an ultrasound is easier, you just have to lay there. It can still hurt a little from the pressure of the ultrasound transducer, but it’s less intense compared to the mammogram which has to squish the breasts in order to look for anything out of the ordinary. Ultrasound gives off no radiation as it uses high frequency sound waves.

Before I left, a radiologist went over the images from both tests. The ultrasound technician came back after speaking to the radiologist to give me the results. I was given a report stating normal/benign findings and that I have dense breasts, which is something I should discuss with my doctor. The report says that dense breasts are normal and common, however they can decrease the accuracy of mammograms and may be a risk factor for getting breast cancer. Only a mammogram can determine whether someone has dense breasts or not, it is not something that can be felt. Ultrasound or other imaging may be ordered for people who have dense breasts because dense breast tissue and tumors both appear white on a mammogram, while fat/adipose tissue appears dark. Normal breasts can be lumpy and bumpy. It doesn’t automatically mean that something is wrong, but again, it’s always worth speaking up and getting it checked out. The APRN followed up with me the next day, confirmed the normal results, and said to let her know if anything changes and that someone will call me to schedule a follow up appointment with her in 6 months.

​I hope this has been informative and encourages you to take care of yourself. Even if you end up needing testing before you ever expected to, it is so important to learn about your body and find out where your health is at.

​No matter where you are at, you are not alone. Public health needs help. During President Biden’s State of The Union speech on March 1st, he mentioned the importance of better cancer prevention and treatment outcomes. We’ve already come a long way in recent decades, but the continuing prevalence of cancer shows that there is more research, education, and innovation to be had. The President said, “And fourth, let’s end cancer as we know it. This is personal to me and Jill, to Kamala, and to so many of you. Cancer is the #2 cause of death in America–second only to heart disease. Last month, I announced our plan to supercharge the Cancer Moonshot that President Obama asked me to lead six years ago. Our goal is to cut the cancer death rate by at least 50% over the next 25 years, turn more cancers from death sentences into treatable diseases. More support for patients and families. To get there, I call on Congress to fund ARPA-H, the Advanced Research Projects Agency for Health. It’s based on DARPA—the Defense Department project that led to the Internet, GPS, and so much more. ARPA-H will have a singular purpose—to drive breakthroughs in cancer, Alzheimer’s, diabetes, and more. A unity agenda for the nation". (https://www.whitehouse.gov/briefing-room/speeches-remarks/2022/03/01/remarks-of-president-joe-biden-state-of-the-union-address-as-delivered/)
 
Below, I have added helpful links with more information related to breast cancer:

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Brianna Halek
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