2. The Yearly Mammogram Checklist

Is it time to schedule your annual mammogram?  If so, here is a general guide of items to consider:

1. Mammogram every year? Every other year? At what age should I stop?
   • There are several different guidelines currently available with conflicting information that confuses the picture for both primary care providers and patients. We have two articles specifically concerning breast cancer screening recommendations here and here, but this is the synopsis for AVERAGE risk women endorsed by the American College of Radiology and the American College of Breast Surgeons.
     • Average-risk women should have a mammogram every year beginning at age 40.
     • No specific end age is recommended. The patient’s overall health should be considered to decide when screening mammography should be stopped. If overall life expectancy due to your current medical condition is at least 5-10 years, continue annual screening mammography.
   • Understand that the biggest risk factor for developing breast cancer is being female. We hear almost every day, “I can’t get breast cancer; I don’t have a family history.” Average risk for developing breast cancer for a woman with NO family history is 1 in 8.  We are all at risk for developing breast cancer. Don’t hide behind the false security of no family history. More women develop breast cancer every year who do not have a family history compared to those women diagnosed who do have a family history due to the sheer number of new breast cancer diagnoses each year.
   • See this article to determine if you have additional risk factors for developing breast cancer that would increase your risk above average. This article discusses the difference in screening recommendations if you are considered high risk.
2. Timing
   • Most insurance companies require mammograms to be scheduled 366 days apart. Check the date of your last mammogram and ensure you schedule your next mammogram one year plus one day past that date.
   • Plan ahead! If you are not having any new breast symptoms, consider not scheduling your mammogram right before a vacation. Remember that the results of your screening mammogram might require you to come back for additional imaging and possibly even a biopsy. Give yourself at least 2 weeks before leaving town if you are going to schedule your screening mammogram prior to a vacation. Ideally, we encourage you to enjoy your vacation and schedule the screening mammogram for after you return. Chances are good it won’t matter, but better to be prepared for the worst-case scenario versus worrying during your vacation or even possibly canceling it.
3. Prior mammograms
   • It is extremely helpful to bring a few of the most recent mammograms from other facilities if applicable when you come in for your screening mammogram.
     • More women are called back for additional imaging when prior mammograms are not available, either because this is your first mammogram or because you are changing facilities, and the prior mammogram is not available for comparison.
     • If prior mammograms are known to exist but are not available on the day of the exam one of two things may happen:
       • Your mammogram will be read without the benefit of comparing it to the prior. The chance of you being asked to come back for additional imaging is increased without the benefit of a prior mammogram to be used as a comparison. Additionally, new subtle developing cancers may not be seen because small cancers can look just like normal breast tissue. Radiologists look at your prior exams along with the current exam to determine whether anything in your specific tissue has changed.
       • Your mammogram may not be read right away but will be put into a hold status while the facility works to track down your prior mammogram. Facilities have 30 days to issue a report for the mammogram.
   • If you are switching facilities, PLEASE take a moment to do the following BEFORE scheduling your mammogram:
     • Find your most recent mammogram report. Write down the facility name including city, state, and phone number if possible.
     • If you can’t find a report, call your doctor’s office as they should have a record of your most recent mammogram and be able to give you this information.
   • When scheduling your mammogram, provide this information to the scheduler.
     • If the prior mammogram is from another state, you may be required to sign a medical release form. Trust me, it is worth an extra trip if you need to do this in person. Please sign the form prior to your mammogram appointment!!!
     • Once the new facility has this information, they will be able to request your prior mammogram in order to have it available for the Radiologist by the time of your scheduled mammogram.

By taking a few moments to go through this checklist prior to scheduling your mammogram, you are giving yourself the best chance of scheduling the correct exam at the correct time while providing as much information as possible to allow the Radiologist to do their job to the best of their ability.