Pain during mammography: characteristics and relationship to demographic and medical variables

Reports of pain during mammography show that there is great variability in both the incidence of reported pain (0.2-62%) and the intensity of that pain. Much of that variability may be due to the measures used to rate mammography pain. This is the first study that has examined the incidence, quality and intensity of mammography pain using a variety of pain measures. A sample of 119 women undergoing screening mammography was studied using four pain scales, three well-validated measures frequently used in the pain research literature as well as a pain/discomfort measure frequently reported in the radiology literature. A large proportion (up to 91%) of women report having some degree of pain during mammography. The intensity of that pain was typically in the low to moderate range, but a small proportion of women (< 15%) reported intense pain. The incidence of reported pain was related to the pain measure used. Pain measures that provided a woman with many options for reporting pain were associated with a higher incidence of pain than a scale that provided only one or two options. Thus, some of the variability in reported incidence of pain during mammography can be explained by the pain scale used in the study. Demographic and medical variables could explain 18-20% of the variance in mammography pain. Two of the variables that were shown to consistently predict a painful mammographic experience were (1) average pain at the last mammogram and (2) breast density. This study demonstrated that the pain measure selected for use in a particular study may depend on the population being studied. A college education was found to be an important predictor of pain scores on the McGill Pain Questionnaire. Thus, this pain measure may be of limited usefulness in studying a population of women with little formal education.