Mammography and Regulatory Overreach

Physicians who care for women in our community are deeply concerned about the temporary closure of mammography services at Winchester Medical Center. We know that regular screening mammograms save lives. We speak for a large number of physicians. We have NO concerns regarding the quality of mammograms that have been done at our local hospital. What we are most worried about is that this situation will be misrepresented and that it will frighten women and keep them from being screened.

Breast cancer is the most common cause of cancer in women. It is the second leading cause of cancer death behind lung cancer. The overall lifetime risk of developing breast cancer for US women is 1 in 8. Screening mammography allows for the detection of cancer before it can be felt, improving the chances of survival. Estimates of mortality reduction vary from 15 to 20%. Early diagnosis also spares patients from more radical surgery, chemotherapy and radiation.  Every patient should speak with their provider about the screening interval that is appropriate for them. Most experts suggest a yearly mammogram starting at age 40.

Every year each mammogram machine is inspected by a physicist to be sure that the equipment is delivering just the proper dose of radiation. Every year a report is submitted by this scientist to the state of Virginia and to the FDA in Washington, DC. On one machine, the normal report made it to Richmond but not to Washington. The absence of this piece of paper in DC triggered a review of mammography services at Winchester Medical Center.

The American College of Radiology reviewed 30 of the 30,000 mammograms done in the past year by our hospital and read by our radiologists. In about a third, they felt that the patient positioning could have been better. The positioning problems in these patients did not change the accuracy of any of the mammograms. An outside review of this tiny sample agreed that there was some issue with positioning but only in a different and much smaller number (5). Again, the diagnostic accuracy was not affected. In other words, this problem with the position of the patient on the table did not cause a cancer to be missed. Most importantly, the statistics in our community for breast cancer detection is better than the US average. We also have lower breast cancer death rates than our neighbors.

We have no concerns about the quality of mammography services at Winchester Medical Center. With an abundance of caution our hospital, in collaboration with our radiologists, has paused screening services for a short time to allow additional training to be completed. If patients want to stay on schedule, we are sending them to the other regional Valley Health hospitals, Progressive Radiology or City Hospital in Martinsburg. Valley Health has agreed to pay for a review of a recent mammogram by an outside source if a patient is concerned. They will also cover the cost of another mammogram if this is necessary. Please call 1-888-441-5294 if you are interested in accessing any of these opportunities.

Laura Dabinett, MD, Kristin DeHaven, MD, James Nashed, MD