If you move or change doctors, make sure you hang on to a copy of your previous mammograms so you can give them to your new doctor. Comparing a new mammogram with an old one can reduce the number of false positives by as much as 44 percent. That’s because if a spot on your mammogram looks borderline, a radiologist can refer to those old records. "If there’s a finding on a mammogram and it has ‘probably benign’ characteristics and has been stable for two or more years, it’s benign," Kopans explains. If your films are being mailed from your previous office, allow at least a few weeks for the records to reach the radiologist before you show up for your appointment — many offices won’t even look at this year’s mammogram until you give them last year’s to compare it with.
Mistake: Not Considering a Second Opinion
You’ve been diagnosed and feel a sense of urgency. But before you race off for surgery, consider this: According to a recent study, when women diagnosed with cancer got a second opinion from a team of cancer experts, more than half the time their treatment plan changed significantly. A second set of eyes on the film or slide sample often results in a reevaluation of initial findings, sometimes diagnosing a more invasive cancer or even a second lump — and sometimes determining that the patient does not have cancer after all. "The mistake is rushing into surgery or letting a doctor talk you out of a second opinion," says study author Michael S. Sabel, MD, a surgical oncologist at the University of Michigan Comprehensive Cancer Center, in Ann Arbor. "Patients have time — a couple of weeks — to seek out a second opinion." The one situation that definitely warrants a second look: when the doctors who initially read your mammogram and pathology reports aren’t dedicated breast specialists. This could be the case if your primary care doctor refers you to a local hospital where the radiologists read all types of film.
Mistake: Not Picking the Right Surgeon or Hospital
Women who chose a breast surgeon based on their doctor’s recommendation were less likely to go to a top cancer center, while women who did research were twice as likely to end up with an experienced specialist and to be treated at a dedicated center (typically, an American College of Surgeons-approved cancer program or a National Cancer Institute-designated cancer center). "Our study showed that referral by a primary care physician was the least common way to get to a specialized center," says Monica Morrow, MD, a surgical oncologist at Fox Chase Cancer Center, in Philadelphia. "As a patient, you need to say that you want to consult a doctor who is a specialist." Studies of cancer surgery have repeatedly found better results for those who are treated by experienced surgeons at dedicated centers. "Doctors who devote their entire career to breast cancer are more likely to know which treatment is cutting edge," Morrow says.
To find a center near you that meets the criteria, go to the state-by-state listing at:
Mistake: Not Investigating Clinical Trials
Before your treatment plan is set, ask your doctor if you qualify for any clinical trials. Although patient care costs may not be covered by insurance, the trade-off is getting therapy that may offer a better survival rate or have fewer side effects while you are receiving high-quality medical care. Being put in the placebo group does not mean you’ll get a sugar pill — you’ll simply get the current gold standard in cancer treatment. "If your own doctor isn’t running such a study or seems reluctant to recommend one, don’t take no for an answer," says Charles M. Balch, MD, an oncologist at the Johns Hopkins Medical Center, in Baltimore.
To find out what trials might be available in your area, go to the following Web sites: