With Mother’s Day approaching this weekend, we have women’s health on the brain. Giving the moms in your life the gift of health awareness is incredibly important. Breast cancer is one of the leading health challenges faced by women in the United States today. However, breast cancer can frequently be detected at an early stage through preventive imaging.
According to the United States Preventive Services Task Force (USPSTF), women between the ages of 50 and 74 should get a mammogram every two years. The National Cancer Institute states that randomized clinical trials demonstrated that mammograms have reduced the number of deaths from breast cancer among women ages 40 to 74. The Affordable Care Act covers screenings beginning at age 40, and women under the age of 50 should speak with their care provider to discuss family history in order to determine when and how often to receive these tests. Particularly, women with family history and certain risk factors may consider imaging even prior to age 40 as well as alternatives to the standard mammogram including 3-D breast tomosynthesis, MRIs, and ultrasounds. Being in the imaging business, we have an interesting perspective on mammography and would like to share some less commonly discussed concepts that tie into preventive testing.
Access to Priors
A radiologist looks for changes in breast tissue overtime. Some women may have non-cancerous conditions such as cysts or high breast density that require monitoring to make sure no questionable changes have occurred. Without previous imaging work, it is difficult to tell if abnormalities are part of a woman’s natural anatomy, or if they are stemming from another cause. Having the ability to easily access prior studies is critical in these situations and prevents unnecessary additional testing. In addition, the storage of breast imaging has now become a legal issue. The FDA has warned healthcare facilities that in 2016 it may take compliance actions if their PACS fails and all images are lost due to lack of secure business continuity and/or disaster recovery plans. A recent Aunt Minnie article cited several compliance issues at mammography facilities over the last few months, including a site that lost over 20% of its imaging!
The inability to access historical studies may result in a retake of the imaging. This means another appointment and possibly time off work for the patient, money wasted for both the patient and facility, additional frustration and stress, and unneeded radiation exposure. We’ve discussed at length that imaging exams must do more good than harm and although mammograms have low levels of radiation, redundant imaging is still not ideal. Frequently, even if a patient brings in a CD containing her mammogram, unreadable or poor quality may result in additional imaging work. Online image transfer is a great solution to this potential problem. Ella Health, a women’s health facility with eight locations throughout Pennsylvania, empowers women to take control of their health with an innovative approach to providing services including mammography and physical therapy. With DICOM Grid’s technology, Ella Health has built an agile process around image management and is able to execute on several key initiatives for storage and sharing.
According to the Mayo Clinic, among women of all ages, 10% of mammogram results will lead to additional tests, including biopsies. The good news is most abnormal findings aren’t cancer or a serious condition. Women with abnormal mammograms may not only want to ask the radiologist if the imaging was compared to priors but also seek a second opinion from another specialist. In order to do this, you need the ability to easily send images to other, out-of-network doctors.