"But the radiologist was only in the room for a few minutes, how can they make a decision that quickly?"
"They hardly looked at the screen! They didn't even examine me"
I have heard and read this enough that I feel an explanation is warranted. The veterans here know these facts well enough but there maybe some new to breast imaging, and this forum, that do not. This applies primarily to breast ultrasound and to full-time breast imagers.
1) US is digital and can be viewed immediately on the PACS unit in the rad's office. In fact the rad can often watch you being scanned in real time. When the tech finishes and says that they will discuss the case with the rad they go to the rad's office where they can review the entire case on PACS as well as compare it to all your other studies that are currently on line including your mammogram(s) and related reports. My habit was to review all the old studies while the pt was being scanned in order to save time. A decision is usually made by the rad before they leave their office to talk to you unless additional history is required from you to make that decision.
2) There are things in the breast that on ultrasound are immediately recognizable and do not need much time to diagnose. These include the definitely benign and the definitely malignant. They are what in the specialty of radiology are referred to as an "Aunt Minnie". When your aunt minnie comes to your house to visit you open the door and say "oh look its aunt minnie". You dont think to yourself "well she's about 70 years old and is wearing a red sweater; she's about 5'4" 100 lbs...hmmmm.......I'll bet that's my aunt minnie". No, you just recognize her.
3) In all these years of breast imaging I have hardly examined patient's breasts to make a diagnosis. I can see on the screen what they are feeling. Physical exam adds nothing to my impression. If however if the patient feels something and I see nothing on imaging I will do a thorough exam of the breast and attempt to feel what the pt is feeling then re-scan that area myself in the US suite.
So it should not always be surprising if they only spend a few minutes discussing your findings with you.
Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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