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Straight Talk about Mammograms: Let’s Clear Some Things Up

As I approached 40, my gynecologist began to talk to me about getting my first mammogram.  I always knew this day was coming. But what I didn’t know was that I was subconsciously afraid of getting a mammogram.

Why would I be afraid of doing something that could potentially save my life…and has saved so many lives?

My grandmother, Sarah Francis Scott-Clark

My fears stemmed from my memories of watching my maternal grandmother lose her battle with breast cancer at the age of 65.  I was young when she died, and at that time, I did not know what was causing her illness. I was much older when I finally understood that what caused her death was breast cancer. Additionally, my fears also came from a lot of things that my friends and relatives told me about mammograms….like they hurt.

After getting my first mammogram, I decided to write about it as a way to inspire and remind women to get their mammograms (Turning 40: Why Getting My First Mammogram Was Such a Big Deal for Me)   And that post started a great dialogue with my friends.  Many of them thanked me for reminding them to schedule their mammograms. And others talked about their experiences.

What I learned from this experience is that there is a lot of information floating around about mammograms…and some of it is not true.  I also learned that many women are not placing enough importance on ensuring that they get their mammograms.

Don’t they know that this exam could literally help to save their lives.

And that’s when I decided to talk to Dr.Hedwige Saint Louis (MD, MPH, Assistant Professor of Obstetrics & Gynecology, Dept. of Obstetrics & Gynecology, Morehouse School of Medicine.)

I wanted Dr. Saint Louis to clear some things up for me and my friends…….

Ronnie: My maternal grandmother died of breast cancer.  My doctor told me that I should start getting mammograms when I turned 40.  But my first cousin’s doctor told her that she should start at age 35? What age should women start getting mammograms?

Dr. Saint Louis:  From 40 to 50, women should get mammograms every two years. And after 50, women should get them yearly. The only time that this recommendation changes is if you have a first degree relative (like your sister or your mother) that has been diagnosed with breast cancer.  If your mother had breast cancer pre-menopausal (before the age of 50) then the recommendation is for you to start getting screened 10 years prior to the age that she was diagnosed.

So for instance, my mom was diagnosed with breast cancer at the age of 37. So I started to get my mammograms at the age of 27.

Ronnie: This next question is not necessarily about a myth. But my friend told me that it is not uncommon for women to be asked to re-do their exams.  My doctor did not prepare me for this reality. And I think that if I would have been asked to re-do my exam, that I would have assumed that something was wrong….I would have been so worried. So, is it common to be asked to re-do your exam?

Dr. Saint Louis:  It’s very common and women should not be concerned.  When you go to your exam, the person that is doing your mammogram is a Radiology Technician.  They will take a picture and they will take a quick look at the picture to see if there is anything grossly abnormal. If they see anything grossly abnormal, then they would call the Radiologist on the spot and the radiologist would come and talk to you.  But if they don’t see anything clearly abnormal, they’ll tell you that there is a chance that you may have to come back because the Radiologist will have to look at those films and feel comfortable that he/she sees everything that he/she needs to see in order to say everything is negative.   So when they say that you have to come back, more often than not, it just means that until the radiologist takes a look at it and says that it is fine…..they can’t promise you that it is fine.

And then sometimes when they ask you to come back it’s because maybe your breast was not compressed the right way. Or, maybe they missed a little piece of the breast and they can not see that little piece and they just want to make sure that everything is fine. Or maybe there was an area that wasn’t clear and there was just too much interference with the picture…and they just want to repeat the picture to make sure that it’s just interference.

So when women are told  that they may have to come back, it’s clearly one of two reasons.  Either one,  the radiologist has not given it the stamp of approval. So the technician does not want to take the chance of telling you that you’re fine and then something else happens. Or, they just can’t see everything they need to see and they want you to come back for additional views.

Ronnie: Another thing that I was told that concerned me was that it hurt. Will a mammogram exam hurt?

Dr Saint Louis: It is a common myth…I mean if you look at the picture it doesn’t seem pleasant. You’re putting your breast on this plate on this machine. And they’re squeezing the breast. But it depends on what time of the month you go to get your mammogram. So I would recommend that women don’t go get your mammogram the week before your period because your breast are already tender and they’re very lumpy. So don’t go the week before and if you are going to go any time, schedule it for the week after your period when your hormones are at their lowest and it’s when your breast are going to be the least tender.

I think if you have very small breasts or very large breasts, it can be a little more uncomfortable because they have to squeeze a little bit more. This is because it’s an x-ray machine that is taking a picture through the tissue of the breast. And so the bigger the breast, the harder it is for the rays to go through the tissue. And so in those situations they may have to squeeze a little bit more.

So it’s uncomfortable….I wouldn’t say that it is painful.  One of the ways to help is to make sure that when you schedule it that its not the week before your period or during your period. Make it the week after. And you can always take some ibuprofen before you get there to help minimize some of the discomfort.

Ronnie: Dr. Saint Louis before you go, is there anything else important that you think women need to know about?

Dr Saint Louis: I think it is important for African American women to realize that breast cancer for black women tends to be diagnosed earlier. So we tend to be younger. And our breast cancer tends to be more aggressive because we are younger and we are still making hormones.  So it is really important for women to be consistent about getting their mammograms.

I can’t tell you the number of women that haven’t seen me as a gynecologist in years… (and I ask) but at least you’ve gotten your mammogram? And everybody starts looking on the ground..not wanting to look at me. But it’s really important and I think we lose site of the fact that more black women are diagnosed with breast cancer in their mid-forties .  So it is really important for us to be diligent about doing it.  We don’t talk about it as much…but it’s really important for us to do it.

And I think it’s important for you to have that conversation with your daughters. Because one day it’s going to be her health that she will need to take care of . And the more that we make it natural and a part of the everyday annual checkup, the less anxiety provoking it becomes as a task.

Thank you Dr. Saint Louis for all that you do in supporting women to live healthier lifestyles and for empowering women to make healthier decisions for themselves, their children, their families. Let’s take Dr. Saint Louis’s advice and talk about mammograms more often with our friends and family members.

Mammogram Monologues

And this is why I was so excited to be chosen by Hanes as one of a few influencers that will help them spread the word about the importance of early detection and encourage women across the country to schedule their mammograms. We will share our experience, “mammogram monologues,” to help demystify mammograms.

Hanes is proud to be partnering with the National Breast Cancer Foundation (NBCF) for its third consecutive year to help raise awareness of breast cancer and support a cause Hanes’ consumers care so deeply about.  As a longtime supporter of breast cancer awareness, Hanes has made cash and in-kind donations totaling over $1 million since 2009.  This year Hanes will donate $50,000 to NBCF and will donate an additional $1000 because of my participation in this initiative.

Disclosure: I partnered with Hanes to spread the word about the importance of mammograms.  And in return,  Hanes will give a $1,000 donation to the National Breast Cancer Foundation [NBCF] in my name.  All opinions in the article are my own.  Also, I want to thank Dr. Saint Louis for her information.  However, you should always consult your doctor to find out when you should start having mammograms.

Dr. Hedwige Saint Louis, MD, MPH is  Assistant Professor of Obstetrics & Gynecology, Dept. of Obstetrics & Gynecology, Morehouse School of Medicine. She is also the founder of Healthy Mommy, Happy Baby (https://healthymommyhappybaby.com/) a site created to fill the informational and support gap by providing practical solutions and guidance on topics that have the greatest impact on a mother’s quality of life: (1) Health & Wellness, (2) Time Management, (3) Child Development & Education.

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