 | Appropriateness Criteria For Screening And Diagnostic Mammography Studies Washington Radiology Associates is pleased to announce our practice-wide conversion to digital mammography services. This decision to fully convert to digital is based on results from the Digital Mammography Imaging Screening Trial (DMIST results) in which WRA participated. This trial showed the accuracy of digital mammography to be equal to film-screen for all women in the study group, and to be superior for women with dense breasts, women under age 50, and pre- and perimenopausal women. We believe that using the newest generation of equipment, and because of the many peripheral benefits of digital imaging, digital mammography is ultimately better for ALL women.
With digital mammography, patients at WRA now have access to cutting edge technology that will increase our ability to detect early, curable breast cancer. Our radiologists will be able to manipulate (or post-process) the images to obtain a more detailed and accurate assessment of certain findings, such as calcifications and subtle masses. All of our digital mammograms are read by subspecialist radiologists who have undergone additional training and certification in digital mammography.
WRA has also realigned its mammography program to reflect the increased time and complexity required to interpret the more detailed images of digital technology. Starting September 1, WRA will schedule screening and diagnostic mammography appointments only. (Routine “comprehensive” mammograms are no longer available.)
Screening mammography will be provided for patients who have no sign or symptom that might indicate breast cancer, and who do not have a personal history of breast cancer.
Diagnostic (problem-solving) mammography will be provided to patients who have a specific symptom or problem that could indicate breast cancer, or who have a personal history of breast cancer. WRA will continue to perform Computer Aided Detection (CAD) on all mammography studies.
The following chart summarizes the appropriate indications for diagnostic mammography, as well as those situations that are not appropriate. Patients who do not meet the criteria for diagnostic mammography will be scheduled for screening mammography.
Indications for Diagnostic (problem-solving) Mammography:
- Palpable lump or thickening of breast tissue
- Spontaneous nipple discharge, bloody or nonbloody
- Focal (localized) breast pain
- Skin thickening, puckering or retraction
- Abnormal screening mammogram (referred to as a “call-back” for follow-up)
- Short interval follow up of a probably benign finding
- Initial 6 month follow up after breast core biopsy or surgical biopsy
- Personal history of breast cancer
- Axillary adenopathy
- Metastatic carcinoma of unknown primary site
- Breast implants
Situations NOT appropriate for Diagnostic (problem-solving) Mammography:
- Fibrocystic changes or history of breast cysts
- Dense breasts
- Family history of breast cancer
- History of benign breast biopsy or cyst aspiration
- “Lumpy” breasts
- Nonfocal or intermittent breast pain
- History of breast calcifications
- Previously a “call back” from a screening mammogram
- History of “asymmetry”
- History of breast reduction
- Routine or annual exam
This program reflects appropriateness criteria established by the American College of Radiology and we thank you in advance for complying with our screening and diagnostic mammography program guidelines. Our goal is to offer the highest quality, state-of-art breast imaging services performed and interpreted by experts in mammography and breast intervention. WRA is proud to offer digital mammography and we look forward to continuing to provide our patients with the best possible breast health care.
Scheduling Appointments:
Washington Radiology offers mammography services in DC at 2141 K Street NW (near Washington Circle), at our two Virginia clinical offices in Sterling and Fairfax, and at our two Maryland offices in Bethesda and Chevy Chase.
Patients are seen by appointment and a written order from a referring physician is required. To schedule a mammogram at WRA, please have your physician order handy and call Centralized Scheduling at (703) 280-9800.
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