By Kay Quinn, St. Louis Post-Dispatch, January 7, 2008

Getting an X-ray of the breast is still considered the best way to detect breast cancer in its earliest, most treatable stage. But last May, a report from the U.S. Centers for Disease Control showed fewer American women were getting the screening tests. An estimated 1.8 percent of women, 40 and older, skipped mammograms between 2000 and 2005, which amounts to about 1.5 million women.

At the time the report was released, researchers called the drop "statistically significant," and one even went so far as to call the finding "disturbing."

Susan Kraenzle, a registered nurse who is the clinical manager of the Breast Health Center at Siteman Cancer Center in St. Louis, said since the release of the report, experts have tried to determine why fewer women would take advantage of a test that can clearly save lives.

"One of the things that we''re looking at is, women are afraid of the experience," Kraenzle said.

They are not only afraid the test itself will hurt but also afraid the test itself will show they have breast cancer.

Kraenzle said many women find getting a mammogram an emotional experience.

"Sit in that waiting room and you''re in strange clothes," Kraenzle said, "and there''s lots and lots of stuff going on around, and everyone knows someone who''s been affected by breast cancer, everybody in this room, everybody walking out on the street knows somebody affected by breast cancer."

Karen White, 49, of St. Louis, admits to feeling a little uneasy about getting the screening.

"I had breast reduction last year, so I''m a little nervous about it now because (the exam is) a lot different than what it was before," White said.

The test can also be painful for many women, because each breast has to be compressed for technicians to get two clear X-ray images of each breast.

"The compression can get a little tight sometimes," admitted White, who works in the Siteman Cancer Center''s Breast Health Center as a lead technician assistant. "But I know it''s important. We have to have it, and they need to get very good imaging. So I tolerate it."

TEST STRATEGY

If anxiety or discomfort has kept you from getting a mammogram, here are some tips that can help you conquer your fears. Consider limiting caffeine for the month before your mammogram. That can help cut down on discomfort due to tender breasts.

If you''re about to start, or have begun your menstrual cycle, reschedule. Breasts typically swell during the menstrual cycle and Kraenzle said the best time to get a mammogram is about a week after your period ends.

Relax, and if you are feeling tense or have pain during the test, speak up.

"Let the technician know, you know, I''m really scared about this. I''m feeling really, really anxious," Kraenzle said. "We will slow down and take you through it."

White said despite sometimes feeling uneasy about what the test will find, she''s diligent about getting her annual screenings. She encourages other women to find ways to cope with their fears, and not put off a test that could save their lives.

"I know anything''s possible," White said, "but I''ve also heard that early detection is the best. So I do what I''m told when it comes to getting my mammogram yearly, even after my reduction, and just listening and staying prayerful for whatever comes about."