HELP! std of care for follow-up post BC screen vs diag mamm

soccermom

I am really confused and have been searching through old threads for about an hour and can't find the answer...

I will be ten years post diagnosis in Oct. 2013. Every year since finishing chemo, while I had good private insurance, I received a diagnostic mamogram and ultrasound at a specialized breast care imaging center. I also received a breast MRI every other year.

Then 2 years ago I had to switch my insurance to Kaiser HMO. The first year I had to fight to get the ultrasound...they weren't going to do it. They also refused to do a MRI unless the oncologist and /or genetic counselor approved it. I had to go in to see each of them they couldn't just review my records and order it.  The mammogram at Kaiser was a diagnostic mamogram as before, but it was just really stressful the way they did it. After the mammogram, They brought you into the room with the radiologist while he looked at the films and scratched his head. (Unlike the breast imaging center where it was all done behind the scenes while I got a massage, then I went to my breast surgeon in the same building and got the results on the spot.)

The second year with Kaiser I finally had approval for a MRI after jumping through multiple hoops. I decided to get the mammogram first, no one really helped me figure out when to do the MRI. It took a lot of appointments and hassle just to get the MRI approved. I didn't fight about the ultrasound. I went for my mammogram. Much to my shock the tech only took a few views then told me I was done and I'd get the results in the mail in about a week! I told her that was not at all what I had expected or had before and asked what was going on. She told me that the dr had ordered a "screening" mammogram and that was what I was getting. She explained that "diagnostic" was where the dr reads it and you get results on the spot. She said my primary care Dr could probably get the results for me in a few days if I didn't want to wait for the results in the mail.

Head spinning I emailed my primary care dr, asking him to clarify the change in procedure and to expedite the results. His answer was one sentence "Sorry I'm not much help here, I don't know their procedures" I was floored! Didn't answer any of my questions or tell me where to get answers. Didn't have any empathy whatsoever.

I am switching my primary care dr immediately. And Considering switching from Kaiser HMO to a Sharp HMO (my only two options through employer). Can anyone shed any light on this situation?

What is the standard of care for followup? Esp as to screening vs diagnostic mammogram?

Thank you so much!

soccermom

bummmmping