Abstract
Breast cancer is a major killer of American women, with 182,000 new cases and 46,000 deaths expected in 1993. If women over age 50 were to get regular screening mammograms, mortality from this disease could be reduced by about 30%. Although concern about pain is not the most important barrier to mammography utilization, it appears to be a significant concern, especially for minority women. We hypothesized that giving women control over compression during mammography would decrease their self-rated pain, and that a woman's coping style would affect perceived pain. We also investigated the relationship of self- versus technologist compression, amount of force, race, coping style, and pain. Data were collected on 109 women from three sources—a 30-item patient questionnaire prior to the exam, 12 additional patient items completed after the exam, a technologist assessment, and radiologists' ratings of mammogram quality.
Of the 48 women who rated technologist-applied compression and patient-controlled compression differently, 71% found self-compression significantly less painful (p = 0.003). These pain ratings, however, were affected by a number of other factors, including the amount of force applied, demographic characteristics, and coping style. Black and white women responded differently.
The results suggest that changes in the delivery of mammography may have the potential to improve the experience for women by reducing pain associated with the procedure. However, some women may benefit more than others. Further research is needed to standardize the educational information provided to patients and to determine the patients who will benefit the most from patient-controlled compression.
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