Topic: blonde question....very confused

The person who does the mammo is normally a technician.  The mammo is then read by a radiologists and reported on to your Pcp, gyno or whoever you asked or were presribed a mammo from.

If they said it was a cyst, most likely it is.  Did you get a copy of the report?  It would have a BIRAD grade on it.  Somewhere there is a list of what the numbers mean from 0-5 with 5 meaning it needs further investigation like a biopsy. Or further imagining like an U/S which can show a cyst more clearer defined as a cyst.

IF you pcp or gyno sent you for a mammo, then call their office and ask how long it takes for a report.  Or call the rads dept and ask when it will be available.

Remember that 80% of lumps are B9!  Hope and prayers that yours will be too!

With my health plan (Kaiser) it works differently than what wishiwere and AlwaysHope said.

The routine annual mammogram isn't ordered by anyone. I just go in when it is about time. The health plan actually started sending reminder to get it about 8 months after my previous one. Radiology called me the day after the mammogram to say they needed me to come back in for an ultrasound. A radiology tech did the ultrasound and then asked me to wait for the radiologist to read it and come in and talk with me. The radiologist said I needed a biopsy and that radiology would call to schedule it. He also gave me some information on the type of biopsy. 

A radiology tech called to schedule the biopsy. She asked questions about the types of medicine and supplements I take and told me what to not take for the 5 days before (the sheet sent home with me from the ultra-sound also had the list). 

We met with the radiologist doing the biopsy (a different one than the one that read the ultrasound) before going in for the biopsy, he showed us the films and what he wanted to sample and suggested a core needle biopsy but from what I had read I thought VAD would be better for me. After a bit of discussion about the pros and cons, he agreed to do the VAD. 

The radiologist called with the biopsy results and put the referral to the breast surgeon in the computer while he was on the phone with me. I got a call from the surgeon's office that day to schedule my first visit. I liked this method as it kept the delays down.

Maybe now that a breast surgeon is involved, it will work more like AlwaysHope says if a future biopsy is needed. 

How this all works depends very much on the policies of the facility you use.

Until this past January, I had all my mammograms taken at a dedicated mammo facility at my small-town OB/GYN clinic.  I called and scheduled the mammos myself every year.  They were performed by a mammo technician, and the films were sent to the local hospital to be read by one of their radiologists.  The radiologist sent a report to my GYN (even if he hadn't requested the mammo), and I got a form letter telling me "everything is OK" or "you need to check with your doctor about the results of your mammo."  No details or other recommendations were given, in either case--I was just told to talk to my doctor for more info.  I never talked to the radiologist or saw the actual mammo reports.

In Jan '08, I had a digital mammo and ultrasound at a breast clinic in a major university medical center.  My primary care doc referred me there, and requested the imaging and an appt with a breast surgeon because I was concerned about a lump I'd felt.  I cannot schedule mammos there myself--they have to be ordered by a doc.

That's not all that is different from the other facility.  At this breast clinic, a radiologist who only reads breast films interprets the mammo right away, before I'm allowed to get dressed and leave the facility.  The radiologist comes out to the waiting area and gives me a form with the results marked on a checklist (sort of a "BIRADS" report).  There will also be a recommendation about further testing and follow-up, if applicable.  If necessary, the radiologist will do additional views or procedures right then and there, including spot compression, ultrasound, image-guided biopsies, etc.  If time is an issue, he/she will schedule the additional procedures at another visit.  When I was there in Jan '08, the radiologist decided the lump looked suspicious enough to warrant an image-guided biopsy...so he did an ultrasound-guided core biopsy, right then.  He called me at home with the results 2 days later, and told me I should arrange an appt. with a surgeon ASAP.

So, the bottom line is that the role of the radiologist varies greatly, depending on the facility.  Do I trust the radiologist's judgment?  Yes--when it comes to interpreting breast images, and deciding whether or not additional testing is warranted.  The radiologist is an M.D. with specialized training and board certification in radiology.  He or she looks at many, many breast images (depending on the facility), interprets them, and writes the reports.  The "other" doctors (GYN, surgeon, primary care doc) rarely, if ever, see the radiographic images at all--they just see the written report containing the radiologist's interpretation. 

I agree, though....this is all very confusing, and there are a lot of differences in the way this stuff is handled at different clinics.

otter 

I have always carried my films to my breast surgeon appts.  They give them to me in an envelope at the time of the mammo/us and the surgeon's office sends them back to the mammo place.  My breast surgeon always does his own reads of the films and there have been occasions when he disagreed with the radiologist's conclusions.  I agree that it probably depends on the system you are in and what type of mammogram was ordered.  There are the routine mammograms and the diagnostic mammograms.  On the diagnostic, which my bs usually orders for me, he also includes orders for ultrasound if mammogram suggests a need.

I think you need to go ahead and find a breast surgeon/specialist you really like to be followed from now on.  Check out the films and carry them with you to the appointment.