Stop Squeezing So Hard: The Case for Rethinking Mammography

There’s a reason so many women dread mammograms—and it’s not just the awkwardness or exposure. It’s the pain. The compression is intense, bruising for some, traumatic for others. But what if the discomfort isn’t just a downside? What if it’s part of the problem?

Emerging research is now suggesting something far more alarming: that the mechanical forces applied during traditional mammograms might actually contribute to cancer progression.

A 2025 study in Frontiers in Cell and Developmental Biology found that solid stress—compression like that applied during a mammogram—can cause aggressive breast cancer cells to become more invasive. The pressure activated inflammatory and migratory pathways inside the tumor, increasing the expression of IL-6 and SNAI1, proteins associated with metastasis. In other words, squeezing a tumor might not just hurt—it might help it spread.

This is not just a laboratory concern. In a harrowing case report published by the BMJ Case Reports, a woman with no symptoms underwent a routine mammogram. The compression caused intense pain and swelling, and within months, a massive, necrotizing carcinoma had developed in the same area. The cancer was HER2-positive and highly aggressive. Despite treatment, she died just four years later.

This woman’s story haunts me. Not only because of the personal tragedy, but because it raises the question: Did we help this tumor grow by trying to find it?

For decades, mammography has been the gold standard for breast cancer screening. It has saved lives, no doubt. But it’s also built around 20th-century assumptions—chiefly, that mechanical compression is necessary to get a clear image. That may no longer be true. Emerging imaging technologies like optoacoustic imaging, contrast-enhanced MRI, and low-pressure ultrasound offer more comfort and potentially better detection, particularly in women with dense breast tissue.

So why are we still relying on a method that some have rightly dubbed a "torture device"? Partly inertia. Partly cost. And partly, perhaps, a failure to listen to the people most affected: the patients.

It’s time for a shift in how we think about breast cancer screening. Yes, we need to detect cancer early—but not at any cost. If the method itself risks making cancer worse in certain cases, we owe it to women to do better. That means funding safer imaging research, reforming outdated insurance policies that don’t cover newer methods, and asking the hard question: is this “routine” practice still safe?

Breasts are not just diagnostic puzzles. They are part of people’s bodies—bodies that deserve respect, comfort, and above all, care that doesn’t hurt more than it helps.

Let’s stop squeezing so hard. Science is showing us a better way. It’s time to follow it.