Mammograms are awkward and uncomfortable — and now could be less painful

Dr. Constance Lehman is director of breast imaging at Massachusetts General Hospital, which has a new mammography system called Pristina.Jonathan Wiggs/Globe Staff

The experience of getting a mammogram is familiar to millions of women: the awkward positioning, the painful sensation of being squeezed, the anxiety over what the test will reveal.

Breast tissue must be compressed during the test to allow for accurate cancer screening. But it is not comfortable, and for many women it’s so painful — physically and emotionally — that they avoid mammograms altogether.

Massachusetts General Hospital this month became the first US hospital to launch use of a new mammography system designed by Boston-based General Electric Co. that is designed to make the experience more comfortable. The system from GE’s health care division has a hand-held remote that allows patients — not the medical professional administering the test — to control the level of pressure they feel during the exam.

The Food and Drug Administration approved the device in September, after finding that it did not lead to lower-quality images or significantly increase exam times.

“We have women in our community who have hesitated to get a mammogram because of the fear and discomfort,” said Dr. Constance Lehman, director of breast imaging at Mass. General. “We hope they see this as an alternative they might try.”

Mass. General plans to study how the new GE system works for patients. (The hospital also will continue using other traditional mammography systems.)

As image quality of mammograms has improved, allowing for more accurate diagnoses, companies that make mammography systems and doctors and hospitals that provide the exams have focused more on patient experience. Experts say that if the experience of getting scanned for breast cancer is more comfortable, more women will agree to the tests, which could help catch and treat more cancers in the early stages.

The payoff can be significant for hospitals and other facilities that provide the exams, since more scans also mean more revenue. Massachusetts insurers and consumers spent at least $200 million on mammograms in 2015, up from $185 million in 2011, according to state data. Mass. General alone conducts about 45,000 mammograms per year.

“Engaging women in that exam is a really important way to address that fear and anxiety,” said Erin Brenner, product manager for GE’s new mammography system, called Pristina.

The machine also has softer edges and more comfortable hand rests to help patients relax during the scan, Brenner said.

Mammograms produce X-ray pictures of breast tissue to allow doctors to look for possible tumors. Medical groups are divided on when and how often women should get screened; some still recommend annual mammograms starting at age 40, while others say it’s OK to wait until age 45 and get scanned every other year.

GE’s move to let patients have some control over their medical tests is rooted in the growing trend of getting patients more involved in their health care. Studies have shown that even sharing information about mammography with patients before the procedure can help reduce discomfort.

“That’s been very helpful for patients to feel engaged in that process, so you’re not just feeling like you’re having something done to you,” said Dr. Catherine S. Giess, division chief of breast imaging at Brigham and Women’s Hospital.

“Mammography in general is a very personal examination,” she said. “You really have to position and be in intimate contact with the patient. And it’s a scary exam for women because we all have people we love who’ve had breast cancer.”

Brigham has the same parent company as Mass. General, Partners HealthCare, but it is not using the new remote-control scanning system from GE.

Brigham and other hospitals also employ low-tech techniques to make patients more comfortable during scans. Giess said it’s critical for mammogram technologists — the workers who administer the tests — to have strong interpersonal skills, so they can soothe patients by explaining how the test works and why discomfort may be necessary.

Hospitals are also trying to put patients at ease by offering private waiting areas, and comfortable gowns and blankets.

And some are redesigning their mammography units to resemble a spa more than a hospital. Beth Israel Deaconess Medical Center opened a new breast care center last year with a calming color scheme and artwork designed to reduce stress.

But many doctors are intrigued by GE’s remote-control mammography system.

“My God, patients would love that,” said Dr. Rebecca C. Yang, a surgeon who directs the breast center at Lahey Health.

Yang said she frequently hears patients say they don’t want to come back for another mammogram because of the pain: “They could be missing an early detected breast cancer that could be a curable breast cancer because the experience [of the mammogram] was so bad.”

Marlborough-based Hologic Inc., one of the world’s biggest makers of breast imaging systems, and a competitor of GE, also launched a new product this fall that is supposed to make mammograms more comfortable. Hologic’s SmartCurve system is shaped more like a woman’s breast, so the breast does not need to be compressed as much to allow for good pictures, said Tracy Accardi, the head of research and development for Hologic’s breast division.

Accardi, who previously worked at GE, questioned that company’s strategy of allowing patients to control their own compression. She said the compression should be left to medical professionals, to ensure the most accuracy.

“That wouldn’t be a direction we would go,” she said.

GE said a clinical study of patients using the company’s remote-control device in Boca Raton, Fla., found that 45 percent actually compressed their breasts even harder than a technologist would have done, leading to even better images. Similar results were found among patients in Europe, where the device launched first.

Dorothy Bishop, a cancer survivor from Malden, credits regular mammograms with helping doctors find and treat her breast cancer. But she still gets anxious before her scans.

“It hurts when you’re being squeezed,” she said.

Bishop, 54, said she would like to try controlling the pressure herself, as long as a technologist explains how to do it properly.

“That would be the thing you’d have to learn,” she said. “I would be willing to try it, because this is the rest of my life.”