In March 2019, the U.S. Food & Drug Administration (FDA) announced major proposed new rules for mammogram centers that should help keep some higher-risk women safer.
What are mammograms?
Mammograms are considered the best primary tool for detecting breast cancer. To perform a mammogram, the patient is positioned standing in front of an x-ray machine and a technologist places the breast on the shelf-like platform. The technologist then uses a plastic plate to push down and compress the breast tissue while a series of low-dose x-rays are taken.
Once the images are obtained for both breasts, a radiologist studies them to look for any signs of cancer.
Common types of medical malpractice
As a Houston, Texas medical malpractice attorney, I have found the most common negligence in breast cancer misdiagnosis and medical malpractice involves three things.
First, poor technique by the technologist in obtaining the x-ray mammogram images. As the saying goes, “garbage in, garbage out.” If the images are of a poor quality, even a highly-trained radiologist can’t properly interpret them.
Second, interpretation error by the radiologist. In other words, the mammography x-ray images show cancer, but the radiologist misses it and writes in the report that there is no cancer.
Third, dangerous results fall through the cracks. While radiologists are the medical experts who interpret mammogram images, they’re usually in a dark room somewhere looking at a computer screen and certainly rarely, if ever, speak with patients. If they see something concerning, they send a report back to the mammogram facility and physician and depend on them to notify the patient.
Sometimes, though, critical test results get lost in the shuffle between the radiologist, mammogram, and physician. It could be that the facility or doctor just drops the ball and doesn’t pick up the phone to call the patient. In other cases, the radiologist reads the mammogram after normal work hours and calls a mammography facility or physician to leave a voicemail, which doesn’t get returned.
How often should you have a mammogram?
The American Cancer Society recommends the following mammogram screening guidelines, and emphasizes the screening is designed to find cancer before a person has any noticeable symptoms.
• Women 40-44 years old: Should have the choice to have annual mammograms.
• Women 45-54 years old: Should have annual mammograms.
• Women 55+ years old: Should switch to mammograms every two years, or could choose to continue with annual mammograms.
While mammograms are not cutting-edge technology, the technique is important. Since 1992, with the passage of the Mammography Quality Standards Act (MQSA), mammography centers have to be certified annually and must display the certificate in public view.
Current federal standards require mammography facilities to notify patients of mammogram results within 30 days, using easily-understood language. If potential cancer is identified, though, facilities must make reasonable attempts to inform the patient as soon as possible.
Under the new proposed FTA regulations, certified mammography facilities would also be required to provide you with additional information about a particular risk, breast density.
Increased risk of high breast density
Radiologists find it harder to identify cancer in patients with dense breasts. Dense breasts have a higher proportion of fibrous or fibroglandular tissue in relation to fatty tissue. It’s not possible to tell if you have dense breasts by feeling them, so the only way you would be able to obtain this information is from a mammogram interpretation.
In addition to breast density making mammogram interpretation more difficult, recent medical research has shown that dense breasts are actually in and of themselves an independent risk for developing breast cancer.
What you can do
When selecting a mammography center for your mammogram, be sure to look for the MQSA certificate.
Make sure that the mammography center and your primary care physician have accurate contact information for the best way to reach you in the event potential cancer is identified on your mammogram. You wouldn’t want any delay in obtaining critical information.
If you don’t hear back from the mammography facility within 30 days, don’t take it for granted that no cancer was found. Follow up and ask for the results.
Finally, if your mammogram facility or physician haven’t spoken with you about your breast density, be sure to ask about it.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2018, by H Texas as one of Houston’s top lawyers. Also, in 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.