Comedian Sarah Silverman had a "s---ty time" at her most recent mammogram appointment, and she's sharing her experience with her million plus Instagram followers to raise awareness on what's appropriate and what's not.
" ... he smears the gel on with his hands and NO GLOVES on and when he glides the ultrasound wand thing over my breasts he drags his fingers on them and it f-----g bothers me," Silverman wrote on Instagram. She let the radiologist know that this bothered her — something she might not have done years ago.
"... It took many years into adulthood before I spoke up for myself. It's uncomfortable and too easy to think it's all in your head ... Speak up. Trust that thing in your gut that tells you this shit ain't right."
Silverman had the ultrasound procedure after a mammogram because of her breast density, which can make it more difficult for a traditional mammogram to detect cancerous tissue. Dense breasts contain less fatty tissue and more white gland tissue, which appears white on a mammogram and can hide tumors.
For women with dense breasts, getting additional screening, such as an ultrasound or MRI, may be important.
But density can only be seen on a mammogram and is not based on size or firmness or how your breasts feel, according to the American Cancer Society.
So what is appropriate and what can you expect when you have a mammogram?
A mammogram — an X-ray picture of the breast designed to detect tumors — involves placing each breast between two plates so that it’s flattened to get a clear, high-quality image. About 65 percent of women 40 and over have had a mammogram in the past two years, according to the Centers for Disease Control and Prevention.
A mammogram is one of the best ways to find breast cancer before it spreads, but it can make women anxious — especially if they’ve never had the screening.
The American Cancer Society recommends women with average breast cancer risk have an annual mammogram starting at 45; while the U.S. Preventive Services Task Force advises they can wait until 50 and have the test every other year.
What’s it really like to go through it?
TODAY's series "What It's Like" looks at common medical procedures through the eyes of a patient.
Aimee Daley, 44, has been having annual mammograms for most of the last decade because she has a family history of breast cancer: her two maternal aunts, a paternal aunt and her paternal grandmother were diagnosed with the disease before menopause.
So Daley, who is a stay-at-home mom in Chicago, has been vigilant about having the test regularly, she told TODAY. Her most recent mammogram took place last month at Northwestern Memorial Hospital.
When scheduling a mammogram, doctors advise women to avoid the week just before their period, when breasts may be tender or swollen because of hormone changes during the menstrual cycle. Going in for the procedure at other times of the month helps reduce discomfort and get good pictures, the American Cancer Society noted.
As always, it’s not the same for all women: Daley has found the time of the month doesn’t make a big difference in her own experience.
The day of the procedure:
On the day of your exam, don’t wear deodorant, perfume or powder because they can show up as white spots on the X-ray, the CDC advised.
If you forget, Daley has found it’s usually not a problem.
“Most places have wipes — you can wipe off any deodorant or perfumes or lotions that are under your arms near where your arm pit is because they don’t want it to interfere with the pictures,” she said.
Because you may briefly feel discomfort or pain when your breasts are flattened, it may help to take a mild over-the-counter pain reliever about an hour before the screening.
Again, all women’s experiences are different: Daley hasn’t had the need to take a pain reliever.
You’ll have to undress from the waist up during the mammogram, so dress accordingly — it may be easier to wear separates rather than a dress.
During the procedure:
After you’re called from the general waiting area, a technologist will show you into a dressing room where you can change into a hospital gown. Then, you’ll go into the room with the mammogram machine and given a shield to protect the lower part of your body from radiation, Daley said.
The technologist will set you up on the machine, which can be a little uncomfortable, she noted.
“My experience has been that every technician that I’ve ever had is really lovely, understands that it can be an anxiety-provoking situation for women and is gentle,” Daley said. “The discomfort itself is less than a minute… once they get you set up, they just have to take the picture.”
The actual breast compression only lasts a few seconds, the American Cancer Society noted, advising women to tell the technologist if it hurts. Daley described the sensation as something she could “absolutely” tolerate.
Once everything is in place, she holds her breath and stays still, because movement impacts the quality of the picture. Typically, two images of each breast are taken for a screening mammogram, but sometimes more are needed for women with breast implants or large breasts, the American Cancer Society noted.
The procedure is then repeated for the other breast.
Daley had two pieces of advice:
“Don’t be too worried if they need to take another picture. Many people, myself included, get sort of worried like, ‘Did they see something?’ and a lot of times it just has to do with the angle or the breast density,” she said.
If you can see the images on the screen, “try not to be your own doctor because you don’t really know what you’re looking at,” she added.
More images are also taken during a diagnostic mammogram — the same exam, but for a woman who has symptoms. Daley has had this type of test and said it also involved a radiologist who looked at the images while she was still in the room.
Daley resumes her day normally, with no need for any recovery time, she said.
You will usually get the mammogram results within a few weeks, depending on the facility, the CDC noted.
Health insurance plans are required to cover mammograms for women over 40.
Women who don’t have health insurance can turn to the CDC’s National Breast and Cervical Cancer Early Detection Program, which provides low-cost or free mammograms.