Can a Mammogram be “Fun”?

Click the image for other examples of “Mammograffiti”

Mammograms can be a real pain in the boob.  Although recommended as a screening tool, they are not foolproof.  Mammograms failed to detect cancerous tumors in at least two women I know, including a family member. Still, each fall I schedule my appointment, a cross between a medical and psychological ritual.  Even if imperfect and uncomfortable to boot, at least I know I took advantage of the best thing available.  This year, I learned that the Rose Breast Center in Denver, where I’ve gone for a few years, was offering tomosynthesis, a 3-D rendering of breast tissue taken simultaneously with the 2-D mammogram images. For added peace of mind, I decided to get that, too, even though it was unclear from a conversation with my insurer whether they  would cover it, even though, like its 2-D cousin, it is not proven or guaranteed.  As I drove to the center last week, I remembered that I had written about whether it was possible to find delight in a dental chair, and I wondered whether I could approach my appointment with curiosity and appreciation, or at least an attitude other than resignation or dread.

My rather short wait for a technician was pleasantly punctuated by complimentary green tea, fresh from a fancy new beverage machine. There were snacks, too, bags of chips and granola bars. As I sipped, I wondered if the office would continue to upgrade its ambiance; might they eventually bring in caterers offering hors d’oeuvres on round silver platters?  Perhaps the promise of some smoked salmon and creme fraiche on a crisp cracker would ease the harshness of the squeeze. My culinary fantasizing was interrupted by the technician.

“Eye-lona, you can come with me.”

I stood, finished the rest of my tea, and walked over to a smiling cocoa-skinned woman, dark hair pulled tightly away from her face.  I handed her my paperwork in exchange for a pink printed cotton wraparound shirt, warm to the touch, a detail I appreciated. She ushered me to a changing room where I swapped my top for the shapeless half gown, fastened loosely with ties.  A few minutes later, she led me to the exam room, where the mammography machine loomed liked a large robot.

“So you’re getting the tomosynthesis, too?” she asked, after having me repeat my name and date of birth, just to make sure it was me standing there, not an accidental doppelganger or deliberate proxy.

“Yes,” I said.

“That’s more radiation, you know,” she said.

“How much more?” I asked.  I had read about that online, but the figure hadn’t stuck.

“About double that of the mammogram.”

“Really?”

“But it’s within federal guidelines.  If it were dangerous, we wouldn’t offer it.”

While my trust in federal guidelines is not absolute, I wagered the extra radiation was unlikely to harm me faster than an undetected tumor might. I went with it.

“Can I see the images?” I asked, curious about a three dimensional rendering of my bosom.

“Only the radiologist can view the 3-D images,” she said. “He has a different machine for that.  But, if you want, you can look at my screen.”

She arranged my feet, torso and right breast in the designated places.  It’s a highly awkward position that a yoga instructor would tsk-tsk for forcing a human body into an unnatural alignment. Then she lowered a glass plate onto my flesh, squeezing it like someone hellbent on extracting the last drops of juice from an grapefruit. Even though I am not new to this exam, I am still surprised by the breathtaking tightness of the squeeze. Indeed, one must hold the breath while the X-ray is taken, a few seconds that feel like many long minutes.

“You can exhale,” she said, lifting the glass plates. Air rushed out of my lungs. My smock flapping, I walked over to the computer screen, where the X-ray’s mysterious topography reminded me of a lunar landscape.

“Do you mind if I take a picture of it?” I asked.

“Go ahead,” she said.  I imagined that in a busier city or place, taking even a brief hiatus from the procedure would be verboten to keep the flow of patients moving. I rummaged in my purse for my compact camera, then positioned myself near the screen.  My camera sounded a cheerful “bing” as I turned it on.  The technician stood to my right. Looking through the viewfinder, I noticed her reflection on the screen and mentioned it to her.

“Do you want me to move?” she asked.

“Well, I imagine you don’t want to be in my photograph.”  She stepped aside.  I snapped an image, which included a bright spot from the flash.  I took another, with the same result.  Not wishing to create more delays, I put my camera away.

“Thanks for bearing with me,” I said. It had been a relief to have a break.

“No problem, you wouldn’t believe what else I’ve seen in here.”

“Like what?”

“A woman had me take pictures of her with her iPhone while she was in compression.”

“Really?”  I wondered how she could stand being in compression even a few seconds longer than necessary.  Did she share the images on Facebook?

We did the other side, and then it was over. I retied the smock and gathered my belongings.

“I hope you have fun the rest of the day,” I said.

“Sometimes the patients make it more enjoyable,” she said.

I went home and played around with the two images in Photoshop.  That the flash had created a white spot offered some visual and textural balance.  I experimented with colors and shading, creating various breastscapes (I’m calling the collection “Mammograffiti“).  Doing that was a joyful expression of gratitude for my “intactitude” rather than taking it for granted. Still, I can’t claim that the compression was fun, although involving the camera allowed me to feel more like a participant than a patient.  Next year, I’ll turn off the flash and see how that changes my results.