I typically write as a health expert, covering lifestyle-related conditions. Sometimes, though, I‘m a patient — and I like to share experiences that I learn from.
I’ve been going for yearly mammograms since age 40. My mother died of triple-negative breast cancer at age 63. That type of breast cancer lacks the three most common receptors known to fuel breast cancer — hormone epidermal growth factor receptor 2(HER-2), estrogen receptors (ER) and progesterone receptors (PR). So the most common treatments are ineffective. Though I know the likely contributors to her high risk profile (obesity and staying on hormone therapy for an extended period of time) for this deadly cancer, I take my own risk quite seriously, despite trying to live a very healthy lifestyle. Here’s what happened this year and the lessons I learned.
When I called to make an appointment, I found out that the location I usually go to had quite a long wait period. Because digital versions of past mammograms are online and easily available for comparison when the new images are read by a radiologist, I accepted an appointment at another location.
When the technician began the imaging, I was unhappy with the way she placed me in the x-ray machine — I noted that she spent very little time adjusting my body and each breast, and a small alarm did go off in my head. She was also text messaging while she took the images. You’d think because I’m a health professional, I might have spoken up — but I didn’t. I just made some mental comments — the main one being about her lack of professional attitude — and went to get dressed.
Usually, I wait and the technician signals “OK to go — the images are fine.” That means that a radiologist has taken a cursory look at the images to make sure the images are clear and distinct. So when I was told I could leave, my assumption was that a radiologist had signed off on the quality of the images.
I hadn’t heard anything regarding results after five days had passed, so I called my gynecologist. I was told that they were going through a pile of reports and would call back. Three minutes later they called back and said that I needed to return for a diagnostic mammogram and possible ultrasound of one of my breasts due to focal asymmetry.
This happened several years ago — and everything was negative — so I asked how far back the radiologist went when looking at comparison images. I was told to call the imaging center, and they said that images “from 2013 and on” were used for comparison. For some reason I asked if I could speak to the radiologist “who had been there” when I was screened. It was then I found out that no radiologist is ever on site at this location — this was just a satellite screening center. That fact upset me because I assumed incorrectly that when I had been told to leave that a doctor had reviewed the images.
My husband happens to be Chief of Medicine at the hospital where I normally have my mammograms. I called him and said that if I needed a redo and ultrasound, I wanted it done there. He was able to quickly arrange for me to come in that day, and of course, because he has some stature there, the radiologist on site was “put on notice.” The technician was incredibly attentive (to the level I was normally accustomed to) and would not take the images until she was satisfied with each set up. It turned out that everything was negative — and that the quality of the initial images was subpar (according to the radiologist on site at the hospital, who reviewed them).
I could have been saved a fair amount of anxiety and inconvenience if a radiologist had been present at the original imaging location. I might also add that during the second set of images, the radiologist felt the need to reimage my other breast, which exposed me to extra radiation. This was mostly because he just didn’t want to “trust” the quality of the original images.
Several lessons were learned from this experience:
I highly recommend that you have mammogram screening at a “radiologist on site” location. That radiologist will verify that the images are clear, good quality x-rays and save you the anxiety and need to wait to repeat the images if there’s an issue.
Know when the report is ready and be clear on whether you will receive a call or when to call in for the results. Whether the results are positive, meaning some pathology may be present, or negative, meaning free of any visible signs of breast cancer, you need to hear the results. It would be a catastrophe if somehow follow up was delayed or missed and you assumed “everything is OK.”
If you feel that any aspect of the screening experience is subpar — even if it’s just a “feeling,” I recommend speaking up. The technician shouldn’t be texting or unfocused during this very important screening process. If you think that there’s an issue during the session, trust your gut and speak up. I very much regret not saying something during the initial mammogram.
Finally, I recommend finding a location where you trust the imaging technicians and going back to that same location yearly, for quality consistency. I acknowledge that because I’m married to a doctor who has some stature at a hospital where we also utilize services,I was able to get a quick appointment and a quick onsite, thorough reading of the repeat images. I would have been able to schedule a repeat screening with the traditional scheduling system, but I’m not sure I would have had total piece of mind.
It’s important to remember that in addition to mammograms at the appropriate age, self-breast exams or breast awareness and seeing your doctor yearly for a full examination are critical to detecting and diagnosing early breast cancer.
Health professionals, as informed as we are, can still learn from our own experiences as patients. My hope is that you will take note of my story and use the information to make sure you receive optimal services when you go for your next mammogram.
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Known as The HealthGal, expert contributor Amy Hendel is a popular medical and lifestyle reporter, nutrition and fitness expert, columnist, and brand ambassador, as well as a health coach. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, you can find her on Twitter @HealthGal1103 and on Facebook at TheHealthGal. Her personal mantra is “Fix it first with food, fitness, and lifestyle.”