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Breast Tenderness & Cancer Screening Examination

Review on June 06, 2007

Reports that some women experience breast tenderness during mammography screening can cause anxiety and concern in women who are considering testing for breast cancer. To evaluate what asymptomatic women actually experience through mammography, a survey of 1,582 women was performed at seven breast-screening centers.

A group of researchers from the Department of Radiology at the Dana-Farber Cancer Institute in Boston performed a study to determine if women who attend to breast cancer screenings felt some degree of breast tenderness or any type of discomfort. This study was led by Dr. Stomper, who reviewed the records from a several questionnaires and a survey previously performed

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Dr. Stomper's research was also conducted to study the impact of women's previous experiences of breast cancer screening on their subsequent readiness to return and be tested in the future. The women who were examined completed a 43-question telephone interview approximately three weeks after the mammography was performed.

The investigators tried to assess the independent predictors of breast discomfort at mammography while controlling for all other factors. After the imaging procedure, patients quantified pain using a six-point scale. Discomfort was qualitatively evaluated by multivariate analysis.

Patients aged 45-64 years from seven health centers were invited to attend for a second breast cancer screening at a mobile clinic. A questionnaire about their experience of the previous examination was completed by 641 women who attended and 124 who did not attend the second test. Twenty six per cent of the women had found the previous test painful, and a minority also reported embarrassment (7%) or distress (6%). Women who did not reattend were significantly more likely than those who did to report the preceding screening test as embarrassing or distressing and were significantly less likely to have found the clinic staff helpful or attendance for screening worthwhile or reassuring.

Of the 1,582 women who were invited, 1,408 (89.0%) reattended. These women had no breast tenderness or just presented mild pain, so they considered having a mammogram again. The degree/intensity/grade of discomfort was slightly greater in women who complained of breast tenderness within three days prior to the mammogram but was not strongly related to age, menstrual status, or week of the menstrual cycle.

Women recorded their experience on a six-point scale ranging from no discomfort to severe pain. Eighty-eight percent of the women experienced no discomfort (49%) or mild discomfort (39%). Only 9% experienced moderate discomfort; 1%, severe discomfort; and 1%, moderate pain. In other words, the breast tenderness was not strong enough to impede a second test.

The investigation concluded that in most women mammography screening causes no or mild physical discomfort and that actual breast tenderness is an uncommon occurrence.

Note: This story has been adapted from a news release issued by JAMA and Archives Journals.

  • DULLUM et al. Rates and Correlates of Discomfort Associated with Mammography. 2000.
  • EARDLEY et al. Encouraging participation in breast-screening. 1989.
  • ARMSTRONG et al. Screening Mammography in Women 40 to 49 Years of Age: A Systematic Review for the American College of Physicians. 2007