The Mammogram vs. the “Happygram”

Hello bOOb Blogettes:

Today we’ll be looking at the differing exam reports stemming from a woman’s mammogram. Apparently, what the radiologist sends to the doctor who wrote your mammogram prescription (usually a GP or OBGYN) oftentimes differs from what we as patients see. The latter have been deemed “happygrams” by the organization “Are You Dense” founded by the late Nancy Cappello, PhD. This group has done great work trying to mandate that women receive information on their breast density — info which could literally save their life.

Per my interview with Nancy’s husband, Joe Cappello, who now runs “Are You Dense,” this is how it usually happens: The radiologist who reads your mammogram Xray to determine if he/she sees anything suspicious sends a report to the prescribing doctor, explaining what they see on the Xray and how dense your breasts are (;e.g., what category of density they fall into: mostly fatty tissue, scattered density, heterogeneous density, or extremely dense breast tissue).

So your doctor gets this radiology report and may or may not tell you everything that’s on the report in person or otherwise. Soon after, the prescribing doctor’s office instead will oftentimes send the woman a “happygram” report, telling her that the radiologist found nothing on the mammogram and that they can therefore go back to their business of being “happy” again, so to speak.

OR opposite of the “Happygram”: Maybe the radiologist says that they aren’t quite sure they can rule out any cancer by examining the mammogram Xray due to the dense nature of the breasts. In these cases, they most likely will recommend the patient goes back for another mammogram, which of course means more radiation — and this time they are really going to crank up the radiation during this second mammogram exam so that the radiologist can differentiate the white-hued cancer from the white-hued dense breast tissue. Egads…

BUT what sometimes happens is not all the important information that the doctor receives from the radiologist gets conveyed to the patient. And the information might include this: The radiologist has told the doctor that the patient’s breasts are dense enough that an additional screening test with something like an ultrasound is recommended.

This is what happened to Nancy Cappello. Her OBGYN doc decided it wasn’t important (who the heck knows why) to tell Nancy that she had extremely dense breast tissue (only 10% of women fall into this dangerous category) and that the mammography test misses up to 50% of cancers in breasts such as hers. And in fact, it had — for over a decade (remember that most cancers are slow growing and have already been in the breast for anywhere between 2 and 10 years before mammography can pick it up — and they call that early detection???? see my previous blog).

The OBGYN also elected not to tell Nancy that the radiologist had recommended that Nancy get an ultrasound due to her high density. What were they thinking????

It wasn’t until Nancy’s next physical breast exam carried out by her doctor 6 weeks later that a lump was picked up through palpation and then confirmed — not by the additional mammogram, but by the ultrasound. Unfortunately, by this time the tumor was now  Stage 3C, one tiny step away from the dreaded Stage 4. The ultrasound found this large 2.5 cm tumor immediately. But the mammograms that she’d had for 12 years in a row prior had all missed this tumor in its earlier stages.

***The take away here is to ask your doctor what the radiologist report says!  Tell them you want a copy of the actual report and not just the “Happygram” their office will undoubtedly send you a week later after you’ve chewed your fingernails to the bone waiting for the test results.

You have a right to know this information, ladies! Don’t be afraid to ask for it. Doctors are  people too and make mistakes just like the rest of us. And contrary to popular belief, they are not gods. As Joe Cappello said in my interview, if your doctor doesn’t like to be approached with questions from you as a patient, find a new doctor.

Blog at you soon, thanks for reading and helping to spread the word! (Please see the “share” links below).

Stay healthy,

Megan

Megan Smith, M.S.
Director, bOObs: The War on Women’s Breasts

waymarkproductions.com