Transcription:

Melanie Cole, MS (Host): Welcome. Have you ever had to come back for that dreaded diagnostic mammogram? Well, I certainly have. I can tell you that it’s a very scary time. Do you know the difference between a diagnostic and a screening mammogram? And why would you need one over the other? My guest today is Melody Littrell. She’s the manager in women’s oncology and breast programs at the Women’s Hospital. Melody, explain a little bit about breast cancer screening. What are you seeing as far as awareness? Do you see more women getting screened and knowing about screening?

Melody Littrell (Guest): We do. Honestly. We actually have a very high rate of screening mammograms in our community, which is fantastic. We have lots of opportunities for our community to get screened. So we’re very pleased with the number of patients that are coming in to get screened.

Host: Then let’s talk about screening. Who gets screened? At what age? How often? My biggest question is why is there some confusion over some of this information you're gonna give us?

Melody: Sure, yes. You know. There are many organizations that publish guidelines, and these guidelines can vary based on the foundational research done to get these guidelines put in place. However, we use the American College of Radiology and The Society of Breast Imaging for our guidelines recommendations. Which means that we recommend that women start having mammograms at age 40 and have them yearly after that.

Host: Wow. So, okay. So that’s the screening mammogram. Starting at age 40 and then having them every year after that. Do you need a referral for that screening mammogram?

Melody: Well, we don’t really need an order for the screening mammogram. However, we do want to have a physician that we can send that report to incase there are additional studies that need to be done or any follow up that needs to be made.

Host: So as I said in my intro, I've been that person that had my screening mammogram and then got called back for a diagnostic mammogram. Explain to the listeners what the difference is and why would you need one over the other?

Melody: Sure. So a screening mammogram is performed when a woman doesn’t have any signs or symptoms of any breast disease or breast cancer. So this is considered a true screening of the breast tissue. Screening mammograms are often covered under a woman’s preventative services. However, a diagnostic mammogram is done when there is a concern, such as a lump or discharge from the nipple. Potentially some focal pain, or when a previous mammogram or breast imaging exam has shown an area of concern and the patient needs follow-up.

Host: So that’s exactly what happened to me, but also, they weren’t sure about what they saw because I had dense breasts. So where does that fit into this picture of screening versus diagnostic?

Melody: Screening mammograms for breast cancer can be done on any type of breast. Dense, not dense. It doesn’t really matter. A screening mammogram is still the best tool for that. However, when we take into consideration the density of a person’s breast, it basically is just that. It’s just more dense tissue. Harder to see through. However, we use tomosynthesis, or 3D mammography, to help us see through that density.

Host: So then if you do spot something suspicious and we have to come back for a diagnostic mammogram or other study, such as a whole breast ultrasound, then what is the procedure like? What is the process like when a woman has to get that news, “Well, we really need you to come back?”

Melody: Sure. So we do our best to make sure that the patient’s anxiety level isn’t too high, for one. So I've been that person as well having to come back for additional studies myself. So I have been in that perspective, and also from the managers perspective. What we try to do is just let the patient know that there has been an abnormality, or a change seen on their screening mammogram. That we just want them to come back for some additional studies. Oftentimes, those are specialized mammogram views or potentially a breast ultrasound. Then if that abnormality persists on those additional images or ultrasound, then the radiologist could recommend a short term follow up exam in say six months or potentially perform a biopsy depending on the index of suspicion that the radiologist has.

Host: That certainly is a scary time for women. So they go through all of this. Maybe they have the whole breast ultrasound and they have their diagnostic mammogram. What if something is found and it’s cancer? What resources do you offer to help guide a woman through that next part of her life?

Melody: Absolutely. We actually have a very unique program. We refer the majority of our newly diagnosed breast cancer patients to our multidisciplinary breast program where they can see all of the providers needed in a single appointment setting. So we have breast surgeons, medical oncologists, radiation oncologists, plastic surgeons, and genetic counselors available to meet with the patient one on one to discuss their role in the treatment of breast cancer. This multidisciplinary approach has really allowed us to get the patient from diagnosis to treatment faster. Once the patient knows that they have a cancer diagnosis, then really, they want to move through this process as quickly as possible. Our multidisciplinary program has allowed us to help them with that.

Host: Isn’t that great how you can help women? It’s such a scary time of life if you’ve been told that you either have suspicion in your breast screening or that you do have breast cancer. How does somebody make an appointment for that screening mammogram? When you're telling us that, reiterate why it’s so important for women after the age of 40 to get that screening mammogram?

Melody: So screening mammography is truly the only screening tool that has the best ability to reduce cancer death. So we feel very strongly that an annual screening mammogram truly saves lives. We have many ways for our community to make appointments at our facilities. One is by calling us at 812-842-4995. Or we also actually have scheduling capabilities within some of the referring physician offices so that when the patient is leaving their physician office, they could go ahead and schedule a mammogram right there at that moment.

Host: Wow. What great information. For women, this is such an important tool that we have now that we can hopefully spot something nice and early. Just tell women what you’d like them to know about keeping healthy breasts and getting their regular screening. And, Melody, just generally being our own best health advocate.

Melody: Absolutely. I think a lot of times as women, we tend to put ourselves last. This is one part of life that I feel like women need to put ourselves first and we really need to take that 30 minutes every year just to be screened, have a mammogram. It’s not always the most comfortable procedure that we have. However, it takes mere minutes. And, again, mammography can truly save a life.

Host: Here, here. Great information Melody. Thank you so much for joining us and allowing women to hear your expertise in this area. Thank you, again, for being with us. For more information or to schedule a mammogram, please visit deaconess.com/twhbreast. That’s deaconess.com/twhbreast. Or call 812-842-4995. This is the Women’s Hospital, a place for all your life. I’m Melanie Cole.