Given 1 in 3 women diagnosed with breast cancer are aged 70 or over and Public Health England is urging older women to take more responsibility for their own breast care*, has anyone considered that our antidiluvian screening technology might just have a role to play in the statistics? For isn’t pain the best way to deter women from going back for more?
Recently, like many women before me, I dutifully attended my local NHS breast screening portakabin, strategically sited at the back end of a supermarket car park– supposedly so you can have your screen and then go do the weekly shopping as if nothing has really taken place.
There were two nurses. One to check you in and one to do the screen. They were that lovely mix of nurturing and no-nonsense which immediately conveys that someone around here knows what they’re doing – bright, chirpy, thorough, professional and yet with 5 minutes between appointments, they had every reason to need to be speedy. A leaflet was pushed towards me, the script delivered at a sprinter’s pace and in a way they’d said it to all before me and would be saying it to all the 70 women that day who were destined to visit the unit.
But this was all process foreplay. The experience of having my breasts clamped by this machine was agonising beyond words. It’s not momentary, like a vaccination – ouch and over. No. The pressure is incrementally increased to squash the breast to ‘get a good image’ until you feel the inside workings of your breast are about to implode. Then it’s held, held, held, and in the excruciation, you’re encouraged to hold, hold, hold until that moment of sweet relief when the plates go into automatic release.
With three of these routine procedures already under my belt over the years, I thought I knew what was coming. But this time, clamped in, no escape, the compression became so intense that the distress to my body burst forth in big, hot tears that ran quietly down my cheeks. Unbearable, squashing pain while the machine moaned its way inexorably, for the umpteenth time that day, across pre-programmed areas, well-practised in its physical abuse. For that is how it felt. The relief was indescribable once the plates relented, but both breasts were reeling from the experience for the rest of the day. The aftershock equivalent of a devastatingly whopping earthquake.
The nurse explained that experiencing pain wasn’t to do with the shape, size or degree of fleshiness of the breast, but related to a woman’s sensitivity. That meant some women were more sensitive than others to the effects of the compression and I was clearly in the former category. This got me pondering. Surely such medical processes should be designed with the most sensitive of the users in mind as their starting point?
We flinch in horror and disbelief at the barbarism of the Dark Ages – racks, breast rippers, head crushers, pillory torture – but what real progress have we made if we are meting out an equally torturous act on 70 women a day in one town in the name of high-tech breast cancer prevention screening? Multiply that up and down the country over one year and the statistics are staggering.
My intention here is not to put anyone off using this much-needed health screening service. Its very existence is to be entirely applauded and valued both at macro and individual levels. But I know many women – big chested, flat chested, the lot – who all report a fear and loathing towards breast cancer screening because of the pain and discomfort. As one friend said, ‘But that’s all there is – and if you want to know you’re clear from breast cancer, then you have no choice’.
So the point is, why if so many women loathe and complain about this mid-life mammary torture, is nothing changing in response? Why isn’t there a true choice? Why isn’t there a radical improvement in or rethink of the diagnostic tool, one that has at its design core a desire to honour the fragility of women and respect the sensitivity of this oh-so female of body areas? More interestingly, why aren’t we as women demanding this? Is it possible that the time and investment aren’t being made because we’re not speaking up about the cruelty of this technique?
Why in an era where medical science and its bedfellow technology are so evolved, have we not identified a more tender, supportive, less aggressive, less imposing diagnostic technique? One that honours the preciousness and tenderness that a woman’s breasts represent to her and others, rather than treating them like two sardines experiencing their fate in a tin processing plant? If men’s screening for testicular cancer had a similar technology – they use ultrasound – I’m pretty convinced we would soon hear screeching from the rooftops and the alternatives would quickly flood in.
I sat in my car after the screening, confronting my new, true sensitivity. I watched as two women left the portakabin, both walking hurriedly to their cars and driving off even more quickly, as if escaping from a nasty dream. The supermarket would have to wait. Tinned sardines certainly weren’t going to be on the menu tonight.
* http://www.bbc.co.uk/news/health-33503198
