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Musings on mammograms

August 1, 2007

In June, I went to Westfield Imaging for my mammogram. It always amazes me that mammography remains such a painful test, despite all the technological advances made in blood tests and imaging. A breast is not a two dimensional object, yet medical science insists on smashing it flat in order to best view any abnormalities within it.

The technician who preformed the exam was horrible. Maybe she is new to the profession, or maybe she is just a sadist. She grabbed and yanked my breast onto the plastic shelf of the machine. Then she wedged the top plastic plate of the machine into my shoulder, right into a pressure point where the arm and shoulder join. I have used this point in karate to drop large men. It was excruciatingly painful and when I asked her to adjust the plate, she told me to be still and not breath. Not a problem, as I was about to pass out from the pain. Perhaps this is a new technique: cause pain else where and the patient won’t notice the pain as the breast is compressed into a pancake.

A week later, I received a call informing me that “An area requiring further examination” had been noted on the film. Wonderful. I went back about a month later for the additional tests. Again I sat in the small closet that resembled a photo booth. The seat was a wood bench and there was a full length mirror on the opposite wall. A box of Kleenex, a spray can of deodorant and cloth gowns in plastic wrap sat next to me on the bench. After changing into the gown, opening in the front, I opened the curtain, sat down, and waited. I could see the legs of the women seated in the booths on the opposite site of the narrow hallway. Also waiting.  (more)
A technician came for me. Thank God, not the same one as the previous visit. This one had some compassion. She throughly explained what she was doing. She also was willing to readjust the machine to ease some of the pain. After taking three films, she escorted me back to the photo booth to wait for the physician to review the films and decide if I needed an ultrasound. If you guess that an ultrasound was required to further investigate “the area of interest”, you win.

I was escorted into another room where a different technician was to perform the ultrasound. After squishing a gallon of K-Y Jelly on my chest, she proceeded to search for the “area of interest”. A knock sounded at the door and the technician said “Come in”. Excuse me ! ! Hello, I am lying here on the table, breast exposed, slathered with goo and she says “Come in”. Of course, this must be an emergency, like her kid fell of the jungle-gym and his brains are splattered all over the playground. Or her husband was killed in a plane crash. Wait, no, it is just the other person asking her to stop by later. And this couldn’t wait ?

After completing the ultrasound, the technician exits the room through a door which connects the two exam rooms. She leaves the door open and I have an unobstructed view of a woman cleaning K-Y Jelly from her breast. And you thought peep-shows were a thing of the past after Disney cleaned up Time Square. When the technician came back in, I told her “You might want to close the door as the woman in the next room may not want me watching her”. The technician just giggled. Can one be more unprofessional?

Next to troop into the room was the radiologist. She did her own scan of the breast. I’m not sure why the technician had bothered to do one. When she was satisfied that she had throughly looked at “the area of interest”, she told me that I needed to schedule an appointment for a biopsy. I guess doctors are very pressed for time these days. I would have expected to at least have an opportunity to dress and speak to the doctor in a more comfortable position. Not on my back with a chest covered in cold K-Y Jelly. And then the doctor asked if I wanted to see the lump. Ah, no. I have no need to be formally introduced to the lump in my breast. We will not be on speaking terms. And besides, have you seen ultrasound images ? They look like Rorschach tests.

I left the imaging center with my mind racing as I tried to process what had just occurred. From the completely unprofessional and dehumanizing experience of the testing to the fact that I might have cancer.

By the time I arrived home, I had already decided that I wasn’t going to bother with a biopsy, but rather just have the lump removed. The pathologist could then perform all the tests she wanted to her hearts content. And, having made my decision, I promptly put any thoughts of the lump out of my mind. Until it was removed, nothing would change if I spent the time worrying and stressing about it. So, out of mind it was.

Until I received a call from the imaging center on Tuesday, that is. When I had called originally to set up my appointment, I had been told by the receptionist that the center had no previous files on me. OK, things get lost, especially since it was 6 years since my last mammogram and the center had moved it’s Summit office to Westfield. The woman on the call told me that a clerical error had occurred, and my previous films had been found. Yippee. And the doctors had reviewed the previous film, compared it to the current film, and there is no need to have a biopsy. Huh? Say what ? The film from 2001 and 2007 show the same breast structures.

In 2001, the mammogram had been completely normal. This one, had required additional films and an ultrasound. And they are the same. Has our litigious society gotten so much worse in the past 6 years that the imaging center felt the need to “over read” the films ? Or perhaps breast imagining and cancer screening is a very profitable business. Insurance picks up the tab for most, if not all the cost. Most patients, I would imagine would want to err on the side of more tests to definitively diagnosis a tumor, not wanting to chance missing something.

I really hope that my experience was an aberration. I would imagine that many people would have spent the past 6 weeks worrying about their future. In my case it turned out that a clerical error resulted in unneeded tests. The clerk should be forced to have one mammogram a day for a week as punishment, no radiation, just compress her breast in the machine. Maybe that would make her more careful in the future when handling peoples’ paperwork.

Because of the poor performance of the Westfield Imaging Center, I do plan to bring the films to another radiologist for review. So say a prayer and cross your fingers that the films really show everything is normal. And of course, do not under any circumstance go to Westfield Imaging Center for your mammogram.

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