Screening or diagnostic mammogram after three years

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sunny1157
sunny1157 Member Posts: 24
edited September 2014 in DCIS (Ductal Carcinoma In Situ)

I was diagnosed with DCIS in August of 2011 and had a lumpectomy and SAVI radiation in September and October of that year.  After that, my BS ordered a diagnostic mammogram on my "bad" breast every six months and yearly on the "good" breast.  After two years of good reports, I was told I could go back to my yearly mammograms.  I went yesterday, thinking  I would get my results right away.  My BS had checked screening.  The technician explained to me that my others had been diagnostic that's why I got my results when I was still there.  For screening you get a letter.   Do any of you know if this is normal protocol?  I'm about to go crazy worrying!

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited September 2014

    yes, with a diagnostic mammo,  the radiologist looks at it  right away and you get results before you leave.  With a screening mammo, you get either a letter in the mail (everythings OK) or a phone call if there is a problem. generally, you have diagnostic mammos for 5 years after a bc diagnosis. (but that could differ with different facilities and physicians.

    anne

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  • redsox
    redsox Member Posts: 523
    edited September 2014

    That is the difference between diagnostic and screening mammograms. There is no standard for how long a diagnosis of DCIS gives you an order for a diagnostic mammogram. 

    You should just appeal to the ordering physician to specify diagnostic, emphasizing how nervous you are waiting for results. I am not that nervous but much more than before the diagnosis. I also have at least three physicians who will order the mammogram so you can shop for one who gives you what you want. 

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  • sunny1157
    sunny1157 Member Posts: 24
    edited September 2014

    I received my results yesterday and everything was fine.  It took eight days to get the results and I did get less anxious as the days passed.  Next year, I will ask my doctor if it can be diagnostic. 

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  • lmdi
    lmdi Member Posts: 15
    edited September 2014

    If you feel better getting the diagnostic mammograms, I think you can just ask your doctor to continue with them. I'm not sure there's any firm critera because even before my DCIS, my doctor always ordered a diagnostic with ultrasound (I have a lot of calcifications and a family history of BC).

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  • proudtospin
    proudtospin Member Posts: 5,972
    edited September 2014

    Sunny, I am 6 years out and had the diagnostic mamos for the first 3 years and always got them before I left.  Sure was a relief.  But now get screening ones.  I am in NJ which is what you note, mine is done at University Radiology which operates rads at a ton of NJ hospital.

    definitely talk to your doc, mine are mailed but this last time, they did arrive in the mail in about 4 days

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  • BLinthedesert
    BLinthedesert Member Posts: 678
    edited September 2014

    I was told that the difference between diagnostic and screening are the number of views.  Additionally, with diagnostic mammograms the order is typically written with the option of ultrasound if something is seen that warrants a closer look.  I never get my results right away, I just assume that all is "good" if the don't call me back into the dungeon ☺

    I am 2 1/2 years out and still get diagnostic mammograms on my "bad" side ... The guidelines suggest 5 years, but I am still considered high risk even without a previous dcis diagnosis, and screening mammography didnt help my diagnosis in the first place, so I feel much safer with my 6 month "feel up" sessions ☺

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited September 2014

    I forgot to mention the difference in # of views.  Screening mammo is 4 views, diagnostic is 6 views. Mine is supposed to be diagnostic still, but the facility has been giving me a harder time about it as time goes on. (11 years high risk surveillance with LCIS). Usually they will do it when I am assertive and tell them it's per the doctor's order, but last year they would only do the screening 4 views. Since my breasts are not dense at all and very easy to read, I let it go and didn't push the issue.

    Anne

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  • ballet12
    ballet12 Member Posts: 981
    edited September 2014

    Thank you BL and awb for clarifying about screening vs. diagnostic.  I always assumed that diagnostic referred to the need for magnification views (because there is a "diagnostic" problem to be investigated), rather than the number of views.  I am supposedly getting "diagnostic" but it sounds like I'm really getting screening on the non-diagnosed breast and screening, plus a special magnification of the "tumor bed" (such as it is in DCIS) on the diagnosed breast. I do get the results on the same day.  I assume that I'll be kicked out of diagnostic sooner rather than later.  Ironically, at my major facility. they do 3D mammos for the screening patients but mostly not, for the diagnostic patients, unless there is a specific question which needs addressing. If I leave the cancer treatment hospital and move back to the imaging center at my regular teaching hospital, my pcp will be able to write a prescription for diagnostic mammos every year (did it before with the ALH/ADH, when I knew to ask for the diagnostic mammos).

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  • redsox
    redsox Member Posts: 523
    edited September 2014

    The key difference between a screening and a diagnostic mammogram is the purpose of the test.

    A screening mammogram is ordered for a patient with no known issues to cause concern. It is specifically defined as two views per breast.  These mammograms are collected for a number of patients and then the radiologist reads them at some time after the patient has the test.

    A diagnostic mammogram is ordered for a patient with a known issue to cause concern. It includes the authorization to conduct further testing beyond the two views per breast, which may be magnified or other additional views, an ultrasound, or other tests. Generally, the initial views known to be needed are read by the radiologist while the patient waits and the radiologist determines any additional tests needed. You get at least the initial results and some additional testing as needed immediately. It is done to investigate problems found in screening mammograms. It is also done for patients with a personal history of breast cancer. The issue in this thread is how long a diagnostic mammogram is ordered after treatment for breast cancer if subsequent breast imaging over time has been clear. The ordering physician has considerable discretion on this.  

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  • sunny1157
    sunny1157 Member Posts: 24
    edited September 2014

    For the screening mammogram I had on Sept. 17, the technician did three views on the right breast and four on the left breast.  The left breast was the one that had the DCIS.  She didn't do any spot compressions.  So from what I've been reading, it was kind of in between a screening and diagnostic.  I wonder if some follow-up is also dictated by insurance........seems like most things are now days.  I go to the breast surgeon in a couple of weeks and will see what she says.  Thanks for the replies.  They were very informative.

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