Mammograms, does it matter where?

[Anonymous]

Are there significant differences between the equipment giving mammograms at places like Washington Radiology or Medstar? Or differences in the readings?

I used to go to Washington Radiology but switched to Medstar for convenience. I got an email from Washington Radiology about their top of the line process. Any truth to it being better?

Fwiw I have "dense breasts" so sometimes need follow-ups, but not enough to make a different screening standard per my gyn.

[Anonymous]

I’ve been a patient at the Betty Lou Ourisman center for almost two decades so all of my mammograms are at the same place and it’s easy to track any changes in problem areas.

[Anonymous]

It does not really matter. Your provider should be able to tell you where to go?

[Anonymous]

What’s important is that they can review prior screens as well.

[Anonymous]

It 100% matters where you get a mammogram done.

From the technologists positioning

To the training and experience of the radiologists.

To the daily practice patterns of the radiologist.

Can make a HUGE difference in the quality of read and cancer detection rates.

Is your radiologist interpreting your exam fellowship trained? This is very important- having a MSK or neuro rad interpreting your study is not ideal no matter how experienced they are.

Did you radiologist do breast fellowship at MD Anderson or Sloan Kettering learning for 30 different attendings and leaders of the field? Or did they do breast fellowship at a community hospital from 3 attending who all trained at the same place? (Obviously the former is generally better)

Is your radiologist doing diagnostic interpretations as well as biopsies? And getting constant feedback on what things look like?

Is your radiologist looking at your screen in a dark room uninterrupted and batch reading or are they doing screens “between cases” like diags and biopsies. Batch reading is better.

Additionally some places have internal review and QC double read processes. Others don’t.

The variability in quality is wide.

That being said usually large academic hospitals do a decent job. Washington Radiology also seems to have fellowship trained rads from good and varied training programs institutions (NYU, Pitt, GWU).

[Anonymous]

Yes, I think it makes a difference. But if you're like so many in our area and had insurance changes due to family job loss it will still likely be OK for 1 check. The only concern I'd have is if it is in your family or had a previous scare/reason to watch. Washington Radiology I've been to and is top-tier (and had to change for this year to lower.) I'm a little scared but getting the annual check is the key factor.

[Anonymous]

Do you have family history? I don't, and I just go to Community Radiology and get the enhanced scan. Still here so far.

[Anonymous]

What is the top of the line process? Are you getting a 3D mammogram?

My Stage 1, Grade 1 BC was detected on a 3D mammogram. I had received repeated notices that "very dense" breast tissue made my standard mammograms hard to read. Dense breast tissue is common in pre-menopausal women.

When I mentioned this to my proactive gyn, she immediately wrote a prescription for a 3D mammogram. An abnormality that was later determined to be BC was detected on my second 3D mammogram at age 49.

FWIW, I had no family history of BC and no risk factors that would've led to enhanced screening protocols. Just the gyn who listened when I said past mammograms hadn't seen anything.

[Anonymous]

My story with "dense breasts" and no family history of breast cancer/no risk factors. Age 52.

Had my annual 3-D mammo at "womens health center" associated with local hospital (not DC) - all clear.

Had an ultrasound 2 months later with one of those traveling U/S companies - it showed 2 areas of concern.

Went back to the women's health center, they did their own U/S and said, "There is ONE area that needs to be biopsied." Biopsy confirmed cancer. Recommendation for lumpectomy and radiation.

Got a second opinion at MD Anderson, mammo still didn't show cancer, U/S did in TWO spots, requiring a mastectomy instead of previous recommended lumpectomy.

My takeaway (data point of 1) -

yes, different medical centers have different interpretations.

if you have dense breasts, please get an U/S or MRI. Mammos don't always pick up cancer (at least not early enough)

[Anonymous]

Having imaging done at same place is better for year to year comparisons.

[Anonymous]

Anonymous wrote:Having imaging done at same place is better for year to year comparisons.

This. But you can always get records transferred. I left DC for a few years and when I came back, I brought a CD of my scans.

[Anonymous]

The most important part is going annually.

[Anonymous]

I like to go somewhere that only does mammograms. Also I like Betty Lou Oursman at Georgetown because then you are already in their system and if there is a problem you don’t have to scramble to find a surgeon or oncologist

[Anonymous]

If you have dense breasts, you need to get mammogram PLUS ultrasound. Ask your doctor to write it so you get both.

[Anonymous]

I’ve been going to WRA for years. I credit them with noting a subtle finding (distortion) that eventually turned into a cancer diagnosis. Their equipment and physicians are fine, and the appointments are very efficient, at least at the Park Potomac location where I go - for my most recent screening mammogram, I was in and out under 20 minutes.

What I don’t like about them is their record keeping and notification process. They don’t have a portal, and so for screening mammos you have to wait for a letter in the mail. No access to images. And when I had my biopsy, they have a stupid rule that only the physician that did the biopsy could tell me the result. Well it was a Friday and that physician was out of the office so she didn’t call until Monday (thankfully my gyn also received a copy of the report and called me that same day with the bad news). In contrast, I am getting my cancer treatment at Georgetown, and when I had an MRI there, the images were posted within a few days and when the report was ready I could see it right away (in fact I’m pretty sure I saw it before my doctor).