Friday, August 13, 2010 Marmie asks

Q: Unnecessary testing?

In response to a screening mammogram, a radiology practice called me back for a cone compression mammogram and a possible ultrasound. I am a 53 y/o postmenopausal female. The findings were cited as follows:

Finding 1: There is a focal asymmetry in the 3 o'clock position of the left breast.

Finding 2: There is a dense nodule in the upper outer quadrant subareolar I position of the left breast.

I am an assertive healthcare consumer. I asked for a fee schedule regarding the procedures and they did not have that information. I asked for a copy of the report from the MD who read my screening mammogram, and at one point the tech tried to take it away from me. I advised her of HIPPA laws and she did not seem to be familiar with this. The report included inaccurate information that included a family history of breast cancer (which I do not have) and a statement that I had my first child at age 44 (I was 25). I asked if we could go straight to ultrasound, but was told that was not an option. The cone compression mammogram was quite painful. Afterwards I was told that the ultrasound was indeed necessary. A radiologist came in after a tech completed the initial ultrasound and advised that the "dense nodule" was a lymph node. He stated that it was not enlarged or swollen -- that it was perfectly normal and nothing to worry about. He did state that there is a difference in the amount of fibroglandular tissue between my two breasts and that I should have a repeat mammogram in 6 months. These procedures cost approximately $1000.

I am happy to know that I am in good health, but I'm wondering if these procedures were medically necessary.

- A
- A
- A

Answers (2)

PJ Hamel, Health Guide

8/13/10 5:19pm

Marmie, a lot depends on the facility where you get your testing. What's "medically necessary" to some isn't to others. If they'd found an issue - cancer - then in hindsight, the screening they used would have been necessary. Problem is, it's just really hard to identify cancer sometimes, so most places tend to follow the same path for everyone: mammogram followed by spot compression mammogram folowed by ultrasound followed by biopsy, if necessary.

You might try challenging the hospital on the bill; it can be a lot of work, but it sometimes works. Hope you reach a satisfactory conclusion to all of this - PJH

Phyllis Johnson, Health Guide

8/14/10 6:10am

Marmie, Most doctors would want the information about the nodule asymmetry that only a diagnostic mammogram and ultrasound could provide to properly diagnose you. That does mean that plenty of women will have extra tests, anxiety and expense that turns out to be unnecessary in hindsight. But for many women with exactly the same picture on the mammogram, those extra tests will save their lives.

However, your medical team should have given you better information and treated you more courteously. Because I have a common name, I often find misinformation in my chart that relates to other Phyllis Johnsons. Most of the time, the staff is glad when I call it to their attention, but sometimes I get "attitude" like you did. I have found it best to complain later through the hospital's channels. The hospital will have some kind of complaint-response system set up. Let them know that you want to be able to find out the cost of procedures before you are pushed into them, and tell them your whole story.

Q: Unnecessary testing?

Related Questions

Ask a Question