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Mammography Matters

"What is THAT?!"

Published March 14, 2008 8:08 AM by Wanda Francisco

Digital mammography has certainly changed the environment where I work. Most all of these changes have been very positive and we are now able to whisk our patients through the drudgery of their annual mammogram at warp speed! Our patients no longer have to sift through 10-year-old magazines for some article that looks remotely interesting.

But, there are some unique challenges in a digital world.

So you have taken your first exposure, and the image comes up on a screen that happens to be facing the patient. There is a very large, obvious density.  What do you do now?  How do you respond when the patient asks about the looming abnormality?  

Two of our digital mammography units have screens that are fixed and facing the patient. Our other digital rooms have monitors that can be turned so that only the technologist can see the image when behind the control panel. Sometimes it does amaze me that more patients don't ask about the images that come up on the screen in front of them.

My usual ploy is to try and keep the patient engaged in a conversation, ranging from what the weather was like when they came in, to where they got their cute purse. It doesn't always work. Most patients can be pacified when you tell them that you are merely checking the quality of the images and that the radiologist will be reading their exam later. Some patients are very persistent though and will continue to try and get information from you.   

Trying to remain personable, but not releasing any information is difficult. How do you respond to this type of situation? I am sure that different modalities are also challenged with this situation, how do they handle it, while still appearing friendly to the patient? Hopefully we can all get some new ideas to make our jobs a little easier and help ease the fears of our patients. 

posted by Wanda Francisco
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5 comments
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Over on our March 14th Mammography Matters blog, Wanda Francisco discussed dealing with the questions
April 4, 2008 2:18 PM

We recently acquired Digital Mammography and are going through a process with a study group composed of patients and technologist to get the best process for the patients comfort moving through the mammogram exam.  While we are almost there with the particulars, I personally until otherwise advised, like to show my patients their films and let them see that we have enough tissue on to give the radiologist the best imformation to give them a good interpretation.  They love looking at the MLO and seeing all of the upper outer quadrant tissue  and their pectoral muscle.  I explain this is all I can say as I am not a Radiologist qualified to give an interpretation and could loose my licience at even a hint of an interpretation.

They are excited to see thier films and are fine with this answer.

I wait to see what the process will finally be if we are to continue to show the patient thier images or not.  In my opinion this is a great tool for positioning purposes from the Mammographers standpoint.  
JOANN SOBECKI, Mammography - Lead, st. peter's hospital April 1, 2008 12:08 PM
Helena MT

In my experience with being digital since it's inception in 2005, I find that the patients absolutely love the opportunity to view their images as the images are taken. And if there is an obvious finding, it is simply explained as "what we are going to do is electronically send these images for review with comparison to see if these areas are new or unchanged" I also explain that the technologist do not have the priors for comparison and that reading the mammograms is not the technolgist area of expertise. The Technologist are of expertise is to achieve the best possible images so that the radiologist can give the best possible reading. %0d%0aI strongly believe in educating the patient to help them understand the importance of good positioning, compression and cooperation.
LENORA CORONADO, MAMMOGRAPHY - SENIOR MAMMOGRAPHER, OUTPATIENT March 18, 2008 1:57 PM
DALLAS TX

Depending on the pt. you can say things like "if I told you what was on the screen I'd have to kill you", "I am not a Dr. and I could loose my job if my supervisor/managers found out I had told you anything" usually works though  Our screens face away from the pts. so unless the pts walk away from the machine it doesn't usually come up
Ruth Mejia, mammo - tech, hospital March 18, 2008 10:51 AM

Hi Wanda,

I am sure the fixed screens can be reversible and you can put the service call to face the screens to the mammographer. I agree with you that it is close to imposible not to answer the question when a pateint asks after observing the image infront of them. They even take the normal tissue very seriuously caz they are not sure what it is and always scared to have abnormal mammogram reading.

Those screens need to be changed ASAP.
shital, mammography March 18, 2008 10:40 AM
TX

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