1st mammogram any advice

Hi, I'm 41 and tomorrow I'm having my first mammogram.  I had a physical this week and although nothing was abnormal with my breast exam my doctor thought I should start having mammograms.  I've previously had borderline ovarian cancer and two of my dad's sisters had breast cancer so he thought I should have one now.  I'm concerned about how painful it will be.  I'm overweight and have large dense breasts and my previous doctor said mammograms would be ineffective for me and an ultrasound would be better.  My current doctor is not of the same school of thought.  What is the current school of thought on this?

[japdip]

Usually it is recommended that women start having yearly screening Mammograms at age 40. Very often Mammogram and Ultrasound are done together to give a more complete picture of any abnormality. Even with dense breasts a Mammogram can be a valuable tool, especially as the first screening test to use for comparison at a later date. I have heard women say that a Mammogram is quite painful and some say it is a little uncomfortable but only for a few seconds. I personally find them no problem at all.  Regards .....

[Cheerpul]

Mammograms saved my life.  Last September, my annual mammogram came back with a finding of clustered microcalcifications and a BIRADS score of 5 (5 is the most likely to be cancer score.)  The year before showed nothing in this area.  I've had a mastectomy, found a tiny tumor and had chemo.  Now I am continuing treatment and getting on with my life.

I am overweight, but not large breasted.  The mammograms were a sensation of being squished, but I have stubbed my toe worse many times.  When I had a followup mammogram with small paddles last year, it was much more uncomfortable, but lasted for only a few minutes.  It was like closing my finger in a drawer, but not slamming it.  I think that attitude and relaxation help a lot in handling discomfort.  In my experience, neither one, but especially a regular mammogram was a problem.  I consider it a small price to pay to save my life.

[chelan3]

I'm in Canada, the understanding where I am is 50 is the age to start mammograms so saying 40 is a start is interesting.  Anyone I know 2 people who had mammograms that were clear and within 2-3 months after were diagnosed with breast cancer that's spread.  One doctor said she likely had a small tumor that burst from the mammogram spreading the cancer.  So, that's why I'm a little leary of mammograms and would rather have an ultrasound although I'm concerned about the pain I am more concerned about anything bursting and spreading that could have been caught with an ultrasound.  Especially when my previous doctor who I respected completely said a mammogram with my size would be ineffective.  

[Cheerpul]

I have been having mammograms since I was 40 years old.  When I was 47, last October, I had microcalcifications show up on my mammogram with a BIRADS score of 5.  (5 is on a scale of 0-5 - 5 most likely to be cancer.)  I had a digital mammogram which showed the microcalcifications in more detail and an untrasound the same day that showed nothing.  Completely nothing.  I had an excisional biopsy a week later and was diagnosed with extensive, high-grade DCIS comedo-type (pre-cancerous) cells.  I had a mastectomy a week later and was found to also have had a 5 mm tumor that hadn't shown up on either mammogram, the ultrasound or as a lump felt during any exam.

Without the mammograms in my forties, I would be in a very bad way right now because the tumor was Her2 positive, which makes cancer very aggressive.  I will always advocate mamography screening.  Ultrasounds have a use, but do not show as much detail.   Was your previous doctor talking about digital mammography being ineffective?  It is a more detailed view and improvements are made every year in machines and processes.  I have never heard of a mammogram bursting a tumor.  I am researching that idea.
Thinking of you.

[ncmichigan]

Cheerpul and japdip have given you excellent information and I agree with them 100%.
Like Cheerpul, I've never heard of a mammo bursting a tumor and spreading cancer. I'm  curious to hear what Cheerpul finds on the subject. However, mammograms do save lives and I would never consider skipping one for a few minute of discomfort. I'm 62 and I've been having them since my late 20's due to multiple fibrocystic changes and have had 3 biopsies of 5 different areas just in the past 6 years. I also have large, dense breasts though I'm not large. I would say none of them have been painful except the very last one last month. I had some areas of microcalcs that needed spot compression and it did hurt for the time the picture was being taken and that's it. My last biopsy found LCIS so I get even more frequest testing including MRIs, which aren't fun either, but aren't painful.  The minimal discomfort, or even pain, is worth every minute so that I can have a lifetime of joys with my family, my friends, my work, my hobbies and passions. And I've always believed "not knowing" was WAY worse than knowing what exactly was goig on with my breasts.
Wishing you all the best and hoping you'll have an easy experience with benign findings.
Hugs,
nc

[glzgowlass]

I have dense tissue breasts as well.  I was told it made mammograms harder to read.  The recommendation was to make sure I had them every year and to not skip.  This makes it easier for the radiologist to read any changes because he/she can look at previous mammo's to use for comparison. So it is even MORE important that you have them done regularly.

I can tell you that I had a similar attitiude as yours and put off my mammogram as well as other health issues I should take care of.  Luckily, I had very good doctors who were watching me like a  hawk and called me at home and told me that I needed to get it done.  If it wasn't for them I would have continued to put it off.

Thankfully, I had it done, because they discovered microcalcifications and a bleeding nipple.  It's probable that my conditions are benign.  (I am having surgery on the nipple next week) but what if it isn't benign?  Sure, we think it's a papilloma causing the problems but they need to make sure because it's not certain.

From now on, I will never put off my mammogram again.  I have learned my lesson.  You have an elevated risk because it has occured in your family so you should be vigilant.  

I would suggest that you have your mammo right after a period. My breasts get really tender close to a period and that increases any discomfort so I try to avoid that.  It may help you.  But if it is painful, remember it is temporary.  I've had it painful sometimes and not painful othertimes either way it is worth it, especially with your family history.

Good Luck.