Digital Mammograms Won't Make Screening More Comfortable
The wait for appointments and readings also is affected by the difficulty in finding radiologists who specialize in mammography and breast care, she explains. This is partially because the responsibility to the patients and the governmental regulatory and legal demands placed on doctors make it a complicated and demanding profession.
"Patients expect perfection, but we're trying to diagnose with imperfect methods," she says, comparing the pressure of the specialty with that faced by air traffic controllers. "It's a very interesting specialty, but a lot of radiologists would just as soon not be in that pressure cooker."
Many healthcare facilities don't have a radiologist who deals only with breast care because it's not economically feasible, says Orel. The result is longer waits for mammograms or traveling farther to get them.
In addition, the equipment is expensive, with the digital machines costing about $500,000 and traditional ones a fifth of that. Even without spending the money for the latest technology, medical facilities don't cover their costs for doing breast screening, say Orel and Roubidoux.
"Breast centers are closing because the reimbursement is so bad for mammography radiology," says Orel. "We can't even pay our costs. It is a concern that there will be a crisis in breast care."
But she and Roubidoux say that government regulations covering the type and condition of the equipment used ensure that you will get good mammograms.
You can also take a number of steps to guarantee that your radiologist will correctly evaluate your images.
Roubidoux says in order to be a breast care radiology specialist, a doctor must be specifically trained in it, and the federal government also requires that they take annual continuing education courses. She recommends that you ask if the American College of Radiology has accredited the radiologist and the medical facility. "This means that the facility has been through inspections; you should be able to see a certificate on the wall," she explains.
You can also depend on mammogram centers affiliated with cancer or academic institutions for highly skilled screening because they see so many cases, Roubidoux says. However, she adds that many larger institutions have satellite centers in smaller towns providing care that is just as high quality. For instance, the University of Michigan has several such facilities, and all of the mammograms are sent back to the main campus to be read.
"Consult with your own physician as to what they believe are great places or what places are not so great [for having mammograms]," she says. "They'll know from past experience about their patients' results at different places."
Roubidoux also recommends going to the same medical facility every year for your breast care. "We like to compare," she tells WebMD. "Having all your records in one place, having the continuity, helps ensure accuracy."