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Posted on: May 2, 2008

Mind Your Mammy

Not all mammograms – or doctors – tell the same story

By Dawn Klingensmith
CTW Features

Beginning at age 40 the majority of women undergo annual or biennial mammograms on the advice of the medical establishment. Rarely, however, have breast-health practitioners been put to the test in order to determine if they are providing consistently reliable results.

Research has shown that radiologists’ interpretations of mammograms vary significantly. And even when a lump is found and a patient is called back for a diagnostic mammogram, breast cancer detection depends a lot on the radiologist reading the image, according to a study published in the Journal of the National Cancer Institute.

So what can you do to improve your odds of receiving an accurate reading? Showing up is critical – don’t let studies deter you from scheduling yearly exams.

“You’re not going to find cancer if you don’t go looking for it,” says Dr. Rachel Brem, director of the Breast Imaging and Intervention Center at George Washington University Medical Center, Washington, D.C. “Mammograms are a tried-and-true method of catching cancer in its early stages.”

Make sure your mammography facility is licensed by the American College of Radiology and complies with the Mammogram Quality Standards Act, which establishes quality standards for equipment, technicians and radiologists. Return to the same facility every year if it meets with your satisfaction or, if you go elsewhere, obtain your mammogram images from your previous doctor. Radiologists can detect cancer earlier and avoid unnecessary callbacks and biopsies when they have previous images for comparison, says Dr. Mary Hayes, medical director of the Women’s Imaging Center at Memorial Regional Hospital, Hollywood, Fla.

If you have high-risk factors, including a family history of breast cancer, a more sensitive screening method should be administered, such as an ultrasound or magnetic resonance imaging. Be aware, too, that digital mammograms are better than analog mammograms for women under 50, pre- or perimenopausal women and women with dense breast tissue. Digital mammograms enable radiologists to magnify images and zoom in on certain areas, whereas analog films cannot be adjusted or enhanced.

Because healthy, non-fatty breast tissue and cancerous growths both appear white on mammograms, Hayes likens cancer detection to “looking for a polar bear on snow from a distance.” To extend her metaphor, a person who has ample experience studying the Arctic is more likely to spot a bear, so ask about your radiologist’s level of experience with mammography. Citing a 2005 study, Hayes says doctors with at least 25 years of experience who read more than 2,500 mammograms annually are about 30 percent better at cancer detection than doctors who read fewer than 780 mammograms a year.