It matters who reads your mammogram. If your study is read by a radiology doctor (radiologist) who practices general radiology or another radiology subspecialty and only reads a few mammograms per week, you are probably not receiving the best care. Yes, the guy is board certified and is licensed by law to read your mammogram. But I am licensed to read all radiology studies as well, even though my specialty is breast imaging. Doesn’t mean I should muddle through interpreting the next brain or shoulder MRI that comes my way. Thinking about it now, I am “qualified” to read Peyton Manning’s next MRI of his neck. Do you believe that anyone in their right mind would let me do this? My point: You and your life are just as important as the talented Mr. Manning’s career. Don’t settle for less than the best.
A well-done study published several years ago proves and quantifies this point. The link to the journal article is here - http://radiology.rsna.org/content/224/3/861.short. The researchers found that specialty-trained breast radiologists find significantly more cancers, and at earlier stages, than the general radiologists.
A technologist is a person who is trained to actually obtain the mammographic images of the breast. They attend radiography programs and then gain specific training and licensure in performing mammograms. Although the technologist is somewhat knowledgeable about the appearance of abnormalities on a mammogram, they cannot interpret the mammograms. It is the radiologist who is specifically trained to interpret the mammogram. A general radiologist is able to read mammograms as long as they interpret the required specific number of mammograms on yearly basis. However, there are radiologists who are fellowship trained in breast imaging. They spend an additional year learning the nuances of breast cancer detection and diagnosis. It is a well known fact that fellowship trained radiologists do have better cancer detection rates, are able to find more subtle cancers on mammography and often find cancers at an earlier stage.
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June 02, 2012, 3:54pm
What typical biomarkers or tumor markers are monitored when treating melanoma?
For digital mammography, the average radiation dose from a standard 4-view mammogram of both breasts is 3.7mGy; for film-screen mammography (not digital), the average dose is 4.7mGy. Data suggests that if there is any risk for developing breast cancer because of screening mammography, it is extremely small. In the Swedish Two County Trial, over 100,000 women have had repeated mammograms since the 1970’s, and the screened group has no more cancers than the group who has not had mammograms. It has been estimated that the theoretical risk of mammography causing a breast cancer is one in one million. That being said, we are quite aware that younger breast tissue is much more sensitive to the effects of ionizing radiation, due to more active cell division. Therefore, we use mammography very carefully in women younger than 35 years old.
If a patient is pregnant or could possibly be pregnant when she presents for a routine screening mammogram, it is prudent to delay screening until after delivery to protect the fetus from unnecessary radiation exposure, or to wait until the patient gets her next period in order to be certain she isn’t pregnant. If the examination cannot be delayed because the patient has a worrisome symptom, the patient’s pelvis is shielded with a lead apron when the mammogram is performed.
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May 31, 2012, 7:49pm
Why are laws being considered in some states regarding giving breast density information to women? Which states already have these laws?
A wonderful grass-roots organization has been founded by patients personally affected by the lack of information given to women regarding the density of their breasts (http://www.AreYouDense.org), and they are doing everything they can to address this issue for all women. Because of their advocacy, laws have recently been passed in Connecticut, Texas, and Virginia, requiring that women be informed of their density when they have a mammogram. Bills are also active in several other states, as well as at a federal level. Two of our surgeons at Montclair Breast Center testified last week in front of the New Jersey State Senate Commerce Committee, where a bill was unanimously approved to move to the next step in the process of becoming a state law. Unfortunately, because of strong lobbying by health insurance companies, the bills (except in Connecticut) have been watered down and do not include the mandate that patients’ insurance companies cover the cost of second-level screening tests for women with dense breasts. Hopefully, with enough pressure from the 40% of women with dense breast tissue, this situation will change in the future.
Dr. Orloff obtained his PhD from Emory University in Microbiology and Immunology. In 1993, after completing post-doctoral training in HIV/AIDS at the Centers for Disease Control and Prevention, Dr. Orloff joined the faculty of the Biology Department at Emory. Since 1998, he has been developing the CancerQuest program. The program includes many educational and outreach efforts directed at those affected by cancer.
The goal of the CancerQuest program is to educate and empower those affected directly or indirectly by cancer. The heart of the program is the CancerQuest website. Content on the site includes the biology and treatment of cancer as well as information on possible treatment side effects and psycho-social issues surrounding cancer.
In addition to the actual site content, CancerQuest has produced a variety of multimedia products that include DVDs, CDs, three dimensional posters and high school curricula. Working closely with international partners, material on CancerQuest has been translated into Spanish, Russian, Italian and both Simplified and Traditional Mandarin. CancerQuest members routinely present information to cancer patient support groups, educators, clinicians and attendees at health fairs. CancerQuest has received both national and international recognition for cancer education.
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