How are conflicting screening mammograms resolved, especially when they were done at different facilities with film and digital techniques?

Answers from Sandhya Pruthi, M.D.

The answer to your question isn't straightforward. Most abnormalities found on screening mammograms turn out to be insignificant — in other words, not breast cancer — when additional views are completed. In most cases, it doesn't matter whether the mammogram is digital or film.

What's most important is whether the second facility reviewed the images from your first mammogram. This is necessary to understand what the original concern was, and to determine what additional imaging may be required. You may need more mammogram images, evaluation with other types of imaging tests such as ultrasound, nuclear medicine or MRI, or very rarely a biopsy. If the second facility didn't have the images from your first mammogram, it would be best to return to the first facility for a follow-up exam. Or you can have the images from the second facility sent to the first facility for review in order to decide if you need additional imaging.

It also may be helpful for the radiologist who reads the mammograms to compare the current mammograms with your past mammograms to assess whether the area of concern is stable or new. Another important piece of information in the evaluation of an abnormal mammogram is to find out if you have noticed a new change such as a breast lump or mass, or if your doctor has detected an abnormality during a recent clinical breast examination.

If you are still uncomfortable with the radiology report, then you may wish to get another opinion at a breast center. A short-term follow-up in six months may be recommended to assess for stability and determine if an additional work-up including a biopsy is necessary.

Jul. 11, 2012