Types of Breast Screenings

Many insurance companies are recognizing the benefits of breast screenings. I got a letter just the other day telling me that if I hadn’t been in for a screening mammogram, I should schedule one. My insurance let me know that I could get one screening mammogram per year, free of charge. Oh, the benefits of being over 40, right? Once you hit the grand age of 40, it is recommended that you have a clinical breast exam and a mammogram yearly. A clinical breast exam is done by your physician during an office exam. Clinical exams should begin at about age 20 and be done yearly. Women with a strong family history of breast problems, or breasts that currently have problems, may require earlier breast screenings which must be ordered by your physician. If you are 40 or older, and have normal breasts, you can call to schedule your own screening.

When you call an imaging center to schedule, you will be asked several questions. Skin thickening? Nipple discharge? Any changes in breast size or shape? A breast lump? Changes in an existing breast lump? Breast implants? Why all the questions? Many women are not aware that there is more than one kind of mammogram. If you answer yes to any of the above questions you may no longer be a candidate for a “Screening Mammogram.” You may be scheduled for a “Diagnostic Mammogram” instead, or told to see your physician to obtain an order for a “Diagnostic Mammogram”.

What’s the difference? First of all, a “ Diagnostic Mammogram” will not be free of charge, but most importantly, a “Diagnostic Mammogram” helps to diagnose a problem with the breast, while a “Screening Mammogram” is just screening breasts that are believed to be problem free. While a “Screening” usually consists of 2 views of each breast, a “Diagnostic Screening” consists of several views from different angles. A suspicious area may also be magnified for a more detailed picture during a diagnostic screening.

I run into women all the time that are really upset about this. They have gone in for a mammogram, not understanding that only the “screening mammogram” is made available for free by their insurance. When they receive a bill, they call the hospital, or their insurance, sure that a mistake has occurred. They are told to call their doctor’s office and have the codes changed. Unfortunately, doctors are not able to change billing codes after a procedure has already been done. It is like asking to be charged for a ride in a compact car when you actually rode in a luxury convertible. While they are both modes of transportation that can get you to your destination, they are not the same.

What’s a woman to do? Continue to have your breasts screened as recommended. Getting the right screening, based on your symptoms, is the best way to detect breast cancer. After all, we’re not just doing it for fun! Screening for breast cancer does save lives!