Mammograms Can Be More Stressful Than Cancer

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.