In Search of Quality Mammography

The American College of Radiology credits improved breast cancer survival rates to the Mammography Quality Standards Act of 1992 (MQSA). The MQSA sets national quality standards that all mammography facilities must meet so that all women have access to safe and reliable mammography to detect breast cancer in its earliest, most treatable stages. Mammography centers must be MQSA certified by one of four FDA accreditation bodies—the ACR, and the states of Texas, Arkansas, and Iowa.

Medicaid and Medicare only offer reimbursement for MQSA-certified mammography facilities, which include breast clinics, breast centers or radiology departments in hospitals, mobile vans, private radiology practices, and other doctors’ offices. All facilities are certified for three years or provisionally certified for six months while they undergo accreditation review. Look for the expiration date on your facility’s MQSA certificate, which they should have prominently displayed, and inform the staff if the expiration date has passed.

MQSA mandatory annual inspections make sure mammography facility personnel and equipment meet certain quality standards. The facilities must have specific mammography equipment that is periodically tested and professionals at the facility must have proper training and experience. They must also keep up with technology changes through ongoing education; this applies to the technologist who performs the mammography, the radiologist who studies the mammogram, and the medical physicist who tests the mammography equipment.Each facility must maintain records, have a quality control program, and a implement a system for following up on mammograms that reveal suspicious areas and for obtaining biopsy results when needed.

The quality standards also require that facilities provide patients with a report on mammogram results within 30 days, but some facilities go beyond this and guarantee same-day results through the use of digital mammography which allows the radiologist to view test results immediately on a computer screen.

MQSA also requires that mammography facilities have an established consumer complaint mechanism to address patients’ concerns. If your facility cannot resolve a concern you have about your exam that you think could affect your health, you should contact the facility’s accreditation body about your complaint. The name of the accreditation body is on the MQSA certificate. You can also find the contact information for all four accreditation bodies on the Food and Drug Administration’s website (www.fda.gov).

Many mammography centers offer second opinions and mammogram review services for women with abnormal results or those newly diagnosed at other facilities. Johns Hopkins Avon Foundation Breast Center offers consultative review of mammography films or pathology slides as well as consultations to review treatment recommendations if necessary.

Because the ability of the radiologist reading a mammogram also affects the quality of a mammography, some facilities have two radiologists review mammogram results for each patient. The Huntington Hill Breast Center at Huntington Hospital in Pasadena, California, refers to this as their “double-read protocol.”

To find an MQSA certified mammography center in your area, visit the FDA’s weekly updated website. The Centers for Disease Control and Prevention provides low-cost or free mammograms to low-income and uninsured women through the National Breast and Cervical Cancer Early Detection Program.