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    Use Of Radiolucent Pad To Reduce Mammography Discomfort Among African Americans

    Scientific Abstract:
    Background: Routine mammography screening rates among African American (AA) women remain suboptimal. This is especially troubling since AA women have higher breast cancer mortality rates than White and Hispanic women. Women experience varying levels of pain during mammography. However, AA women report higher levels of mammography pain than White women. In addition, the fear of mammography pain is so prominent that it prevents some women from undergoing routine screenings or follow-ups. Hypothesis: A new FDA-approved radiolucent breast plate cushion has been developed to reduce mammography discomfort without interfering with image quality. However, it is not known whether cushion use significantly impacts the mammography experience of AA women. Furthermore, it is important to better understand whether reductions in exam-related discomfort are more prominent among women anticipating higher, more intense mammography-related pain. We hypothesize that use of the cushion will result in reductions in mammography discomfort, especially among those anticipating higher amounts of pain, and thereby increase mammography satisfaction and routine mammography intentions among AA women. Specific Aims: The specific aims include: 1) Performing a 2-armed randomized trial to test an Enhanced Mammography (EM) condition in which a mammography radiolucent cushion is used and a Routine Mammography (RM) condition in which no cushion is used and typical exam protocol is followed; 2) Evaluating whether use of this cushion will decrease pain and positively impact satisfaction and routine mammography screening intentions among AA women; and 3) Examining the attitudes of mammography technologists toward use of the cushion. Study Design: Approximately 300 AA women scheduled for mammograms at two inner city community mammography facilities will participate in this study. One-half of the women will be randomized to the EM condition while the other half is randomized to the RM condition. Pre and post exam surveys will assess anticipated and experienced exam-related pain, intentions to return for a future routine mammogram, and general visit satisfaction. Potential Outcomes and Benefits of the Research: Interventions to reduce mammography-related pain are understudied. This study will provide insight into how a simple intervention may enhance the mammography experience and serve as the requisite basis of information for future mammography pain reduction studies among AA women. Such studies may have a profound impact on efforts to decrease the breast cancer mortality rate among African Americans.

    Lay Abstract:
    African American women are more likely to die from breast cancer than Non-Hispanic white and Hispanic women. Furthermore, research suggests that African American women may be predisposed to more aggressive cancers than white women, making regular mammograms imperative for this population. The fear of mammography pain or discomfort prevents many women from attending or returning for annual screenings or follow-ups. African American women, however, report experiencing higher levels of pain during mammography compared to white women. Therefore, it is important to conduct studies that evaluate means to reduce mammography-related pain in African American women. The objective of this study is to assess if the use of a mammography breast plate cushion will significantly decrease the level of discomfort experienced by African American women during their mammogram exam. The specific aims of this study are to: 1) Scientifically test a condition in which a mammography radiolucent cushion is used against a condition in which no cushion is used and a typical exam is provided; 2) Evaluate whether use of this cushion will decrease pain and increase satisfaction and routine mammography screening intentions among African American women; and 3) Examine the attitudes of mammography technologists toward use of the cushion. Approximately 300 African American women will be recruited from two Midwestern inner city mammography facilities. The breast cushion will be used during the mammogram with half of the women participating in the study and the other half will undergo a mammogram without the cushion. Study participants will be randomly assigned to the cushion and no-cushion groups. Each participant will complete brief on-site pre and post-mammography exam surveys. The surveys will cover anticipated and experienced pain and discomfort during the exam, intentions to return for a future routine mammogram, and general visit satisfaction. The results of this study will be useful in the future efforts to decrease the level of pain experienced during mammograms which, in turn, may be the cornerstone for decreasing the breast cancer mortality rate among African American women.