The Importance of Comprehensive Breast Centers

That's exactly how it should be - you go in for a screening mammo and the radiologist looks at your films right then and there. If more imagining is needed, you take more pictures immediately. If you need MRI, ultrasound or biopsy, head right on over to that room. All results available given to you before you leave for the day with a commitment as to a firm date and time when you will receive your pathology report and the method by which you will receive it. That would eliminate a hell of a lot of stress and time - get in and get out with a preliminary diagnosis in one day. How can we make that happen!!?!

Hi Locsforme, it sounds like an amazing place you went to. I am a patient at one of the most famous cancer centers in the country, and they definitely don't do same day biopsy, that's for sure. They do coordinate team member visits, so that after you have the imaging (if you are an already established patient), you meet with the surgeon. They also try to coordinate several visits in one day, so if you are coming back for MRI, they try to coordinate that with a plastic surgery consult, etc. Same day biopsy doesn't happen yet. I have only had one core biopsy done there, and they did deliver the pathology news as predicted, on a given day. The results from surgeries were scheduled for follow-up visits, and unfortunately, that could be 10 days, because it depended on the surgeon's schedule. I guess if I tried to get the results somewhat earlier, I might have been able to, via a nurse. I don't think they do 3D yet (they must have a reason for that), but their 2D is amazing, much better than the equipment at my previous facility (also a large teaching hospital and breast center). I've got dense breasts, and you can really see through them with their equipment. So, sorry you have so much on your plate (bilateral radiation coming?), but glad they caught it.

If you want faster results and more consolidated scheduling the key steps are:

Go to a Breast Imaging Center in a major academic or large hospital.

When your doctor writes the script, ask that it specify that the mammogram is diagnostic rather than screening, and add any likely contingency tests (magnified views, ultrasound, MRI, etc.). Once you have a diagnosis of breast cancer you should ask for diagnostic mammograms from then on. When you call the Imaging Center tell them you are calling to schedule a diagnostic mammogram. If they tell you that they don't differentiate between diagnostic and screening mammograms when scheduling, go somewhere else.

If you are scheduled for a diagnostic mammogram at a center that has high volume, the radiologist should read the mammogram immediately and you should be able to get at least some of the contingency tests the same day if the initial mammogram indicates the need.

As far as biopsy goes, that requires enough resources that they can't schedule on the fly. If it is pretty clear you need a biopsy, you may be able to get that scheduled with some of the other tests like ultrasound or MRI right before the biopsy.

With screening mammograms the need for extra testing is highly variable and they can't have all those resources sitting around on standby. Have you looked at the amount your insurance company paid for your last screening mammogram?

When I get my mammogram the order is for diagnostic because of fibrostic cysts I always had. Because of this the Dr. added ultrasound also. When I got the mamm. done, it was followed by ultrasound by a different tech. who thought she saw something suspicious. She had a Dr. who must be always in the imaging dept. come and take a look at the ultrasound pics. From there she decided a needle biopsy was best to confirm any suspicions. About 5 biopsies were done and markers placed at same time. The Dr. did a stat on the readings and said she also thought it best to have a lumpectomy even tho the results may be negative for breast ca. It turned out I had R Breast DCIS.

I was fortunate to have a tech. recognize something suspicious, and a Dr. always on hand to go the extra mile and take care of things asap!