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MammogramsFrom: Dr. Ainsworth (ainsron@sbcglobal.net)Thu Jun 10 16:11:24 2004
One of our local mammogram clinics has recently indicated that they want me to order diagnostic mammograms on all patients who have a history of breast cancer, not screening mammograms. My feeling is that screening mammograms are indicated as a first step on all patients without signs or symptoms that warrant extra views. They point to a Medicare publication that states that a radiological mammogram is a covered diagnostic test in patients who have a history of breast cancer. This Medicare bulletin is from 1978, and to me, their use of this argument is simply revenue enhancing, not based on EBM. I have no problem ordering diagnostic mammograms when indicated, but I resist the idea of extra views in asymptomatic women who have had breast cancer several years ago and are clinically free of disease or suspicious areas. Is anyone else getting or sees a good reason for getting diagnostic mammograms in this subset of patients?
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