[HealthPillarWell] Stresses Over mammography Plague Breast Cancer Survivors

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Misty L. Trepke

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Stresses Over Mammography Plague Breast Cancer Survivors

 

By Jennifer Warner

WebMD Medical News

Reviewed By Brunilda Nazario, MD

on Tuesday, February 10, 2004

 

Feb. 10, 2004 -- For a woman who has survived breast cancer, a

follow-up mammogram may be a more stressful experience than her

initial cancer diagnosis.

 

A new study shows breast cancer survivors find mammography two to

four times more stressful than women who have never had breast

cancer or those who are newly diagnosed with the disease.

 

Experts say mammograms can be a stressful experience for any woman,

regardless of her medical history. But failure to get the

recommended breast cancer screening can only increase a woman's risk

by allowing cancers to go undetected.

 

Despite recommendations for annual mammography among breast cancer

survivors, a previous study showed that 30% of these women had not

received a mammogram in the previous year and 41% could not recall

whether they had a mammogram in the previous two years.

 

" This raises the question of why women may be reluctant to undergo

regular follow-up mammograms, " says researcher Maria Gurevich, PhD

of Toronto's Ryerson University and Princess Margaret Hospital, in a

news release. " Our study suggests that perhaps the experience

triggers distressing memories of prior cancers. "

 

Mammograms Induce Stress

 

In the study, published in the current issue of Psychosomatic

Medicine, researchers surveyed 135 women undergoing mammography at a

large cancer center in Toronto. About half of the women had survived

breast cancer, and the other half had no history of the disease.

 

All of the mammograms for the women indicated that they were free of

cancer. But researchers found that women with a personal history of

breast cancer associated mammograms with significant distress, even

when the results were negative.

 

For example, 3% to 26% of breast cancer survivors reported stress

symptoms that exceeded the threshold for acute stress compared with

only 1% to 11% of women with no history of breast cancer.

 

Researchers say that since they had already lived an average of 6

1/2 years after their initial breast cancer diagnosis, about two-

thirds of the women could expect a favorable mammogram result. But

the study showed these women scored even higher on stress scores

than women who were newly diagnosed with the disease, as found in

previous studies.

 

Gurevich says those findings suggest that even routine follow-up

care and good mammography results can still cause anxiety among

breast cancer survivors by triggering memories of earlier bouts with

cancer.

 

" Compared with those with no history of breast cancer, the meaning

and experience of mammography surveillance and cancer-related

medical follow-ups are likely to be different in survivors of breast

cancer, who are at higher risk for developing new primary breast

cancer or a recurrence, " writes Gurevich and colleagues.

 

To Know or Not To Know

 

For women considering a mammogram, experts say it's a struggle

between uncertainty and fears about what might be found.

 

" The problem with mammograms and doing breast self-exams or clinical

exams is the only thing you're looking for is bad news, " says Bev

Parker, director of the Y-ME National Breast Cancer Organization

hotline. " I think we all want to shy away from that. "

 

But by undergoing annual breast cancer screening, Parker says women

can know that they're safe for another year.

 

Wendy Mason, helpline manager for the Susan G. Komen Breast Cancer

Foundation, agrees and says uncertainty can be much more stressful

than the mammogram itself.

 

" The not knowing is more bothersome to a lot of the women because if

they know what's wrong, at that point they can make plans for next

steps and start actively doing something -- whether it's treatment

or follow-up, " Mason tells WebMD. " I think the not knowing causes a

lot more sleepless nights. "

 

Mason says that although breast cancer survivors may have a higher

level of anxiety about mammograms, they are also keenly aware of the

risks of not getting one.

 

" They wouldn't consider not going for a mammogram because they know

that early detection is going to give them the best chance for

successful treatment, " says Mason.

 

Although every breast cancer case is different, Mason says the risk

of cancer recurrence is greatest within the first two years after

diagnosis and that risk decrease with time. Women are considered

breast cancer free if no new or recurrent cancers are found within

five years after their initial diagnosis.

 

Taking the Stress Out of Mammograms

 

The study also found that support from doctors, friends, and family

plays an important role in mediating the stress women feel about

mammograms.

 

Strong support from their doctor reduced stress among women who

never had cancer, but increased stress levels among women with a

history of breast cancer. Researchers say that association doesn't

necessarily mean that the doctors caused their patients' symptoms,

but the patients' distress may have stimulated the doctors' concern.

 

Mason says that finding underscores the point that open

communication between the doctor and patient is critical to easing

women's fears about breast cancer screening.

 

Cheryl Perkins, MD, senior clinical advisor at the Komen Foundation

says asking questions at the time a mammogram is scheduled can help

allay women's fears up front. Those questions should include:

 

*What can you expect during the procedure itself?

*What is the follow-up plan?

*How much time is required to receive your results?

*How accurate are those results likely to be? What is the risk of a

false-positive result?

*What would be done depending on those results?

 

For family and friends of women who are fearful about a mammogram,

Parker says it's important to listen and remind them of the positive

side of breast cancer screening.

 

" Try to validate her feelings and tell her that most women feel the

way she does, " Parker tells WebMD. " It's just something to get

through, and she'll have that peace of mind on the other side of

it. "

 

For fact sheets and other information on what to expect from a

mammogram and other breast cancer issues, contact the toll-free

helpline at the Susan G. Komen Breast Cancer Foundation at (800) I'M

AWARE or the Y-ME hotline at (800) 221-2141.

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SOURCES: Gurevich, M. Psychosomatic Medicine, January/February 2004;

vol 66. Bev Parker, director, Y-ME National Breast Cancer

Organization hotline. Cheryl Perkins, MD, senior clinical advisor,

Susan G. Komen Breast Cancer Foundation. Wendy Mason, helpline

manager, Susan G. Komen Breast Cancer Foundation. News release,

Health Behavior News Service.

 

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C 2004 WebMD Inc. All rights reserved.

 

www.dukeandthedoctor.com

[Guest guest]

Hi Misty,

 

Interesting article - mammograms not only cause stress, they can also

cause torn ligaments!! Which happened to me the last time I had a

mammogram lots of years ago. What a painful experience that was. The

technician pulled and stretched and squished so much that I couldn't

even use my left arm for a few weeks - the ligaments under my arm were

torn. So I will NEVER have another mammogram until they come up with

some other technology.

 

Carol M

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<http://www.bluegreensolutions.com> http://www.bluegreensolutions.com

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Misty L. Trepke [mistytrepke]

 

Stresses Over Mammography