Interventions for relieving the pain and discomfort of screening mammography

Miller, Dawn; Livingstone, Vicki; Herbison, Peter

doi:10.1002/14651858.cd002942.pub2

Cited by 48 publications

(21 citation statements)

References 26 publications

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“…13 Therefore, it is important for radiographers to explain the procedure well and reassure females before and during mammography. 14,15 Of the patients, 20% patients had doubts about participating in the screening programme because of the IMD. Some females also contacted their cardiologist to ask whether it was possible to perform mammography with an IMD.…”

Section: Discussionmentioning

confidence: 99%

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Paap¹,

Witjes²,

Landsveld-Verhoeven³

et al. 2016

BJR

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Objective: To assess the image quality of mammograms in females with an implanted medical device (IMD), to evaluate pain and anxiety during mammography in these females and to investigate the experience of radiographers. Methods: Image quality was evaluated by two radiographers and one radiologist in the images of females with an IMD participating in the Dutch screening programme (clients). Pain and anxiety were scored using a Numeric Rating Scale in both clients visiting a screening organization and patients from the Isala Hospital, Zwolle. Experience of screening radiographers was collected with a questionnaire. Results: Images of the breast with IMD showed reduced contrast in craniocaudal (CC) and mediolateral-oblique (MLO) views [by both the radiographers and radiologist (range: 11-29%)], less projected breast tissue [only radiographers; CC lateral side: 25.5%, 95% confidence interval (CI): 18.7-32.2] and reduced projection of the pectoral muscle (only radiographers; MLO width pectoral muscle: 31.5%, 95% CI: 24.4-38.7). Clients experienced more pain and anxiety during mammography in the breast with IMD compared to the breast without IMD in the breast (pain difference CC: 0.48 6 0.16, p 5 0.003; pain difference MLO: 0.46 6 0.16, p 5 0.004; anxiety difference 1.30 6 0.22; p , 0.001). Patients experienced more pain (1.05 6 0.12; p , 0.001) and anxiety (1.22 6 0.15; p , 0.001) after placement of IMD. Radiographers are more cautious, more anxious and use less compression during mammography of breasts with IMD. Conclusion: Image quality in a breast with an IMD could be improved by projecting more breast tissue on the mammogram, thereby including (part of) the IMD between the paddles, if required. In addition, radiographers should pay sufficient attention to reducing discomfort both before and during the screening examination. Advances in knowledge: Little is known about the quality of mammography in females with an IMD or how these females and radiographers experience the screening examination. The results of our study showed that having an IMD could result in a suboptimal mammogram and increased discomfort.

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Section: Discussionmentioning

confidence: 99%

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Paap¹,

Witjes²,

Landsveld-Verhoeven³

et al. 2016

BJR

View full text Add to dashboard Cite

show abstract

“…29, 42 Obese women may have higher anxiety regarding physical privacy, embarrassment regarding weight, and perceptions of increased pain and discomfort from the procedures. [43][44][45] In addition, obese women may delay preventive exams because they encounter negative attitudes or judgmental behavior from health professionals, they do not want to be weighed, or they do not want to receive lectures regarding weight. 42, 46-48 Improving patient-physician relationships and interactions are needed to overcome these barriers.…”

Section: Discussionmentioning

confidence: 99%

Cancer Screening in WomenBody Mass Index and Adherence to Physician Recommendations

Ferrante¹,

Chen²,

Crabtree³

et al. 2007

American Journal of Preventive Medicine

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Objectives-Reasons obese women are less likely to obtain mammograms and Pap smears are poorly understood. This study evaluated associations between body mass index (BMI) and receipt of and adherence to physician recommendations for mammography and Pap smear. Results-After adjusting for sociodemographic variables, health care access, health behaviors, and comorbidity, severely obese women (BMI ≥ 40 kg/m 2 ) were less likely to have mammography within 2 years (OR 0.50; 95% CI 0.37, 0.68) and Pap smear within 3 years (OR, 0.43; 95% CI, 0.27,0.70). Obese women were as likely as normal weight women to receive physician recommendations for mammography and Pap smear. Severely obese women were less likely to adhere to physician recommendation for mammography (OR 0.49; 95% CI,. Women in all obese categories (BMI ≥ 30 kg/m 2 ) were less likely to adhere to physician recommendation for Pap smear (OR's ranged 0.17-0.28; p<0.001). Methods-DataConclusions-Obese women are less likely to adhere to physician recommendations for breast and cervical cancer screening. Interventions focusing solely on increasing physician recommendations for mammography and Pap smears will probably be insufficient for obese women. Additional strategies are needed to make cancer screening more acceptable for this high-risk group.

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“…Other studies have shown that up to 35% of all women receiving mammograms complain of pain (24.7% did so in this study), and that pain serves as a deterrent to repeating mammograms among all women. 38 We could only identify one small study that evaluated the relationship of obesity to pain from mammograms, and this study did not find that obese women reported more pain with mammograms. 39 The reason obese women may more frequently report pain remains uncertain.…”

Section: Discussionmentioning

confidence: 95%

“…Thus, clinician-oriented interventions likely cannot, by themselves, fully address the complexity of patient barriers to mammography completion among the obese. Patients in general and obese patients in particular may benefit from interventions to reduce pain, such as patient-controlled compression 38 or, ultimately, the use of alternative technologies for breast cancer screening.…”

Section: Discussionmentioning

confidence: 99%

Patient Barriers to Mammography Identified During a Reminder Program

Feldstein

Perrin

Rosales

et al. 2011

Journal of Women's Health

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Background: Patient mammogram reminders are effective at increasing screening, but patient barriers remain. We evaluated patient characteristics and reported barriers for their association with mammogram completion after a reminder program. Methods: This retrospective cohort study used data from electronic records and a subgroup survey. Participants were female Kaiser Permanente Northwest health maintenance organization (HMO) members aged 50-69 who were 20 months past their last mammogram (index date) and had received a reminder intervention (n ¼ 4708). A mailed survey was completed by 340 of 667 (50.2%) women who received it. The intervention was a ''mammogram due soon'' postcard 20 months after the last mammogram, followed by up to two automated phone calls and one live call for nonresponders. The outcome was mammogram completion at 10 months after index date. Results: Characteristics associated with lower mammogram completion rates were aged <60 (odds ratio [OR] 0.69, p < 0.0001), health plan membership <5 years (OR 0.81, p ¼ 0.019), family income <$40,000=year (OR 0.77, p ¼ 0.018), and obesity (OR 0.67, p < 0.0001). Obese women were more likely than nonobese women to report ''too much pain'' from mammograms (31.3% vs.18.8%, p < 0.01). Younger women were more likely to endorse that they were ''too busy' ' (19.1% vs. 6.4%, p < 0.001) and had more worries about mammogram accuracy (2.5 vs. 2.3 on a 5-point scale, p < 0.05). Pain mediated the relationship between obesity and mammogram completion rates (indirect effect ¼ À0.111, p ¼ 0.008). Conclusions: Important barriers to mammogram completion remain even after an effective mammogram reminder system among insured patients. Tailored interventions are necessary to overcome these barriers.

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Interventions for relieving the pain and discomfort of screening mammography

Cited by 48 publications

References 26 publications

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Cancer Screening in WomenBody Mass Index and Adherence to Physician Recommendations

Patient Barriers to Mammography Identified During a Reminder Program

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