Sunday 05 February 2012

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When I googled 'breast pain', it came up with 8 million pages

Critics say that mammograms lead to needless worry and unnecessary treatment. But isn’t it better to be safe than sorry, asks Cherrill Hicks

A woman examining her breast.
A woman examining her breast. Photo: PHOTOLIBRARY.COM

Having put off the appointment for several weeks, I dutifully attended my local breast screening clinic for a mammogram last month. I know mammograms are a good thing but, like many women, I loathe the procedure: having each breast squashed very firmly flat in a giant clamp so they can be X-rayed is not my idea of fun.

So, despite the cheery ambience, the freshly painted pale lemon walls, the smiling radiographer, I had to take a deep breath as first one breast and then the other was gently manhandled on to a metal plate and a second plate brought down to flatten it, as far as it possibly could be flattened, first from the top, then from the side. The jolly radiographer said this had to be done to get the best X-ray results, but knowing this didn’t help much.

“Remember to keep breathing,” she said, positioning me for the shots as if we were both in a game of Twister: bottom out, shoulders down, upper torso leaning back so the breastbone was out of the way. All of this took only a few minutes, but it felt like an infinity before I was released and politely pointed to a room where I could dress and recover some dignity.

A few days later, I woke up with a pain in my left breast – or was it behind the breast, in my chest? It wasn’t severe but felt debilitating, making it difficult to turn over in bed or get up. The mystery pain also seemed to move around: first at the front, then at the side, then near the armpit. Wild, panicky thoughts flitted briefly through my head. Could the X-ray have caused some sinister injury? Did they get the settings wrong – had my armpit/breast been irradiated by some ghastly error?

I’d give it the weekend to clear up, I thought, but the pain got worse. By Sunday, walking in town, I found breathing difficult. Back home, foolishly, I googled “chest pain, left side”: it came up with 429,000 pages. Googling “breast pain” came up with eight million. And an internet symptom-checker, also for left-side chest pain, listed 37 possible conditions including costochondritis (inflammation of the chest wall), pleurisy (inflammation of the lung membranes), lymphadenopathy (swollen lymph nodes) and heart attack (I told myself it couldn’t be that: the pain was definitely on one side, rather than radiating from the middle). By Sunday evening, my anxiety levels were soaring.

Come early Monday morning, I was on the phone, competing with heaven knows how many others in the race for that elusive same-day GP appointment. Finally I got to see nice Dr S. He ruled out pleurisy, after listening with his stethoscope for any crackling in the lungs. He then felt the lymph nodes near my armpit (after tentatively asking whether I wanted a chaperone, which made me laugh: I’ve known him for years and he attended to both my children), but found no swelling. Like me, he pretty much ruled out cancer, since breast pain on its own is not a common symptom. In any case the mammogram results would be with us shortly.

Finally, Dr S concluded I had suffered a strain of the pectoralis major, the large fan-shaped muscle over the front upper chest, probably brought on by an awkward movement. It could, he agreed, have happened during the mammogram. I’ll never know for sure – casting my mind back, I realised that the injury could just as easily have happened during my aerobics class.

I left the surgery feeling relieved, but also wondering whether my latent hypochondria was being encouraged by the wealth of health advice on the internet. Now I knew it wasn't a sign of something ominous, the pain felt quite tolerable; it cleared up within the next few days. The mammogram results came back negative – another three years before I need to go again.

In all the debates about whether the benefits of breast screening outweigh the risks of unnecessary investigations and treatment, I’ve always been of the opinion that it’s infinitely preferable to go. To me, one fact seems incontrovertible: screening can pick up a cancer early, before I can feel it as a lump; a cancer which, left undetected, might kill me.

I just hope that one day, they’ll invent a more agreeable way of doing it.

The NHS breast screening programmes offer mammograms to women every three years between 50 and 70 and is being extended to include women between 47 and 73;

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