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Immediate Mammogram Results Can be Costly

Docs warn that haste can make waste in terms of accuracy

FRIDAY, Dec. 28, 2001 (HealthDayNews) -- Most women would like to get the results of mammograms right after their screening -- unless it would cost them extra money.

That's the conclusion of a recent survey of 120 women at breast cancer screening centers who were asked their preferences on test-result notification.

Sixty-seven percent would prefer the results immediately, but of that group, only 11 percent said they'd be willing to pay the additional $28.22 that the quick turnaround would cost, the survey found. The reason for the added charge: many hospitals don't have the resources to offer swift results, the study researchers say.

In hospitals already equipped with the space and staff necessary to provide immediate results, the additional cost was estimated to be just $4. But even at that price, 60 percent of those who preferred immediate reporting said they'd rather wait for the results, the survey found.

The results of the survey were published in a recent issue of the American Journal of Roentgenology.

Most mammography centers deliver the results by mail. However, a growing number are offering faster results online or even while women wait.

The availability of such services is placing pressure on centers that don't offer immediate results to start doing so. Dr. Sughra Raza, associate director of breast imaging at Brigham and Women's Hospital in Boston and the study's lead author, says such pressure is what prompted her to do the survey.

"There was a great deal of pressure on us from our referring clinicians because they were telling us patients wanted to go to some of the other centers in our area that were offering online or immediate reporting," Raza says.

Given the perceived demand for quick results, Raza says she was surprised that the percentage of women wanting immediate turnarounds wasn't higher.

"We expected even more, because of the fact that we were hearing so much from our referring doctors," she says.

The primary benefits to women who receive immediate results include lessened anxiety about the outcome along with an ability to have additional tests done right away if needed.

But experts say there's a hidden price to immediate reporting -- the accuracy of the results can be compromised.

"Under average circumstances, there's a general sense on the part of radiologists that, overall, the accuracy of reporting may not be as good with immediate reporting," says Dr. Robert Smith, director of cancer screening for the American Cancer Society.

Most radiologists prefer to read mammograms using a "batching process," where a number of mammograms are read in one sitting, Smith says.

"It's preferable when a radiologist can spend an appropriate amount of time reading the day's mammograms in quiet, uninterrupted, in the right light and perhaps with the phone turned off," he says. "Then they are able to concentrate entirely on the mammogram."

Smith says there are, however, some situations that could justify immediate reporting of results. They include "transient areas" where following up is difficult, or cases in which a woman is at high risk of breast cancer or has had previous abnormalities.

"For those at high risk, it may be critical for their peace of mind," Smith says. "But for the average woman who has had normal mammograms, it's a more positive situation to provide the results within a few days."

Raza speculates that with breast cancer receiving so much attention, women feel a greater urgency to learn their mammography results. But, it's important for them to remember that only a small percentage will even require additional tests, she says.

"We need to reassure women that 90 to 95 percent of the time, they won't need to have additional tests done, and that a later report -- whether negative or positive -- isn't going to make any difference clinically," she says.

The American Cancer Society says that about one in 50 women will develop breast cancer by age 50. By age 60, that number goes up to one in 24, and by age 70, one in 14.

The society recommends annual mammograms for women over age 40.

What to Do: Read more about mammography at this National Cancer Institute site. And visit the Y-Me National Breast Cancer Organization, which offers breast cancer support and information.

SOURCES: Interviews with Robert Smith, M.D., director of cancer screening, American Cancer Society, Atlanta; Sughra Raza, M.D., associate director of breast imaging, Brigham and Women's Hospital, Boston, and lead author of the study; September 2001 American Journal of Roentgenology
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