October 15, 2018
Getting a Mammogram? Why Prior Images Are Essential
When I was a practicing breast imaging radiologist, the first question our team would ask women coming into my clinic for a mammogram was, “Do you have your prior images?”
The reason is simple. Just like a human face, each breast is unique. When looking at an x-ray image, it’s simply impossible to determine whether every spot, white patch or dot is a natural part of the tissue or something that has recently developed – and could be cancer.
What can doctors misinterpret without those prior images?
- Benign, non-cancerous masses. Only prior images can show if they are unchanged or shrinking.
- Small calcifications. Again, only prior mammograms can confirm if these have been stable over the years.
- “Questionable areas” that can turn out to be early cancers when they are re-examined months later. Having prior images available enable doctors to spot actual cancers 30 percent earlier. They also result in a meaningful reduction in cancers that have already spread to a woman’s lymph nodes, which makes cancer more difficult to treat and potentially more deadly.
Without a prior image, it will often mean additional x-rays (and radiation for the patient), possible biopsies to check for malignant tissue, and days or weeks of anxious waiting. It’s a lot for any woman to go through.
Mammograms conducted without prior images for comparison lead to thousands of false positives every year in the U.S.
How often does this happen? Mammography data shows that more than 25 percent of patients show up for mammogram screenings without their prior mammograms available. This number seems to be increasing over time – likely a result of patients moving or changing doctors or insurers more frequently. And two-thirds of women do not realize that prior images – known as baseline mammograms – are important to reduce false positives, which increase cost, time, and discomfort (JACR, published online 9/12/18).
The solution: get your prior mammograms. Bring them to your doctor before your next regular screening. Give your doctor the information they need to give a quick and accurate diagnosis.
Under the Health Information Protection and Access Act (HIPAA) of 1996, every woman has the right to request her own mammograms, and receive them promptly for a reasonable fee. Take the first step: Call your doctor and use this sample script or write a letter using this template. Mammosphere’s technology allows for secure electronic transfer of images to and from patients. But women need to ask for this benefit so it is available at their breast center.
Take ownership of your medical records, and control of your healthcare. Armed with your prior images, you can be an active participant in your care and make better, more informed choices for your breast health.
National Mammography Day is Friday, October 19. Request your mammograms this week.
Kathryn Pearson Peyton, MD
Women's Imaging Consultant