By Robert G. Sullivan, Esq. In the United States today, breast cancer is the most common type of cancer in women except for certain types of skin cancer. Breast cancer is also the second leading cause of cancer death in women, after lung cancer. According to the Center for Disease Control and Prevention: 1 in 50 women in the general population who do not have an increased cancer risk due to hereditary factors will get breast cancer by age 50; 1 in 24 will develop the disease by age 60; and 1 in 8 will be diagnosed with breast cancer in the course of her lifetime.
For breast cancer patients, survival and cure depends on early diagnosis, intervention and treatment. Early diagnosis is best obtained through breast self- examination and mammography screening. Mammography employs low dosage x-rays enabling a radiologist to view breast tissue. Mammography is the best of all of the imaging techniques for the early detection of breast cancer.
It is recommended that, for women with no increased risk of breast cancer or abnormality in the breast, yearly screening mammographies begin at age 40. For women with an increased family history of breast cancer, especially of a close family member diagnosed at a young age (before menopause), it is recommended that the first mammography be taken ten years before the year in which that relative was diagnosed with cancer.
There are several things a patient should do when receiving her mammography. First, she should make sure that the x-ray technician and radiologist are both given a complete and accurate breast health history, along with the reasons for having the mammography. Recent changes in health or complaints concerning the breasts should be described in detail as this information could change the way the x-rays are taken.
There are two types of mammography studies. The first is known as a screening mammography. Screening mammographies are performed on patients with no abnormal conditions and who do not present with complaints concerning their breasts. These routine studies are what their name suggests: a “screening” or general check of the condition of the breast tissue. It is best to see your doctor for a breast exam before your annual mammography so that the mammography prescription reflects any abnormalities found on examination.
Screening mammographies involve taking x-rays of each breast at two different angles. First, the breast is compressed and x-rayed from top to bottom. This is called the cranio-caudal or “CC” view. The other view involves compression and x-ray of the breast from a side angle. This is known as the medial lateral oblique or “MLO” view. Although it can be uncomfortable, full compression is important so that the entire breast may be viewed as thoroughly as possible on the x-ray film.
The second type of study is known as a “diagnostic mammography.” This study is completed when there is a particular complaint by the patient or finding by the doctor. It is important that the patient be very accurate and honest in filling out the questionnaire given to her before the diagnostic mammography. Written questions concerning such topics as pain, discharge, lumps, skin changes, and discolorations should be answered thoroughly.
A diagnostic mammography differs from a screening mammography in a number of important ways. Screening mammographies may be performed without the radiologist being involved. The screening mammography films are taken, and checked by a technician to ensure that they are readable or clear, what doctors refer to as “diagnostic quality.” A radiologist will later view the screening mammography films to determine if there are any reasons for concern.
In contrast, a diagnostic mammography requires that the radiologist be present so that the films can be viewed right away. Additional and special views may be taken. These extra views may involve: magnification of the area of interest or abnormality; selective compression of the area with a special paddle; or x-rays taken at different angles. Small and early abnormalities not seen on the routine views of a screening mammography may be ascertained utilizing these additional views.
Whether you are scheduled for a screening or diagnostic mammography, you should never assume that the technician or radiologist has read your file or records. Always alert the personnel of any issue or problem you are having. When following up with your physician, make sure that he or she sends you back for more views if there is something abnormal on examination. Don’t be shy in questioning your doctor about an abnormality, even if your mammography is “all clear,” and insisting on being sent for additional tests or studies if this is the situation.
By Robert G. Sullivan, Esq. New York Medical Malpractice Lawyer – Sullivan Papain Block McGrath & Cannavo P.C.
