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Oncology Service Line: A Change in Focus

Marianne Aiello, for HealthLeaders Media, March 21, 2014

Success key No. 4: digital mammography

Digital mammography has proven to be more sensitive than traditional x-ray in detecting lesions and calcifications in certain groups of women, specifically those who are in perimenopause and those with dense breast tissue. As an added benefit, the digital scans use 20% less radiation per view.

"With any radiation exposure, you have to weigh out the pros and cons of if it's worth being exposed, so being able to offer patients the absolute lowest radiation with the best possible results is ideal," says Jennifer Logan, MD, a physician with Jefferson Radiology, a private practice group based in East Hartford, Conn., with 10 private offices and affiliations with seven regional hospitals, including Hartford Hospital, where she serves as radiology director for the Division of Breast Imaging. Hartford Hospital is a 867-bed teaching hospital associated with the University of Connecticut Medical School. "If you don't get enough radiation, you don't get good photos and you don't pick up disease; with digital, you get to pick up clearer pictures and it's less radiation, so it's a win-win."

Hartford has been using digital mammography since 2007 and in April 2012, with the acquisition of a portable digital mammography unit and a mobile van, the hospital began taking its imaging technology to corporate sites, mental health institutions, and community sites, such as churches, to improve patient compliance.

"We're reaching an important and vulnerable population, and it's such a dramatic improvement reading the digital images," Logan says. "We're doing the absolute best for these patients, and we're bringing our state-of-the-art equipment out there to people who don't have the resources to get to an imaging facility or can't get to an imaging facility. It's coming to them, so our hope is to catch more women, bring them in, and make it as easy as possible."

While the van and its digital mammography equipment were expensive, Logan says it was worth the investment. Since the van was deployed, 2,200 patients who may not have otherwise gone to Hartford for their care received screening mammograms. Those who needed follow-up care were scheduled at the hospital's imaging center.

"In general," she says, "digital mammography helps to increase the efficiency of a mammography department—saving time by not having to do film processing—so you can increase the capacity of your units to get more patients in. It's expensive equipment to buy, but you have to invest to have state-of-the-art equipment; so it's worth it for the benefit for patients."

Logan believes the next diagnostic technology coming down the line for breast care is tomosynthesis, a 3D mammogram that uses x-rays and can provide a higher-quality diagnostic image compared to conventional mammography.

"It's the same modality as mammography, but eliminates some limitations of even digital mammograms," she says. "It's been approved by the FDA for clinical use. At this point it's not clear if it'll be used with the screening population or to work up abnormalities that were detected. Once the best clinical use for 3D mammography is determined, it may prove to be the next big thing."

Reprint HLR0314-6


This article appears in the March 2014 issue of HealthLeaders magazine.

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