As this may depend on each practice and what technology is available, and as the initial mammogram may vary (2D mammogram, 2D+3D mammogram or 3D+synthetic mammogram) by practice, it can be useful to ask your local radiology facility for direction on writing the order.
Mammography using 3D/tomosynthesis is the preferred primary screening modality. If a patient is at high risk for breast cancer, supplemental screening with MRI is also appropriate (if she can tolerate that). If a woman has dense breasts and, after discussion, she desires supplemental screening ultrasound, an order can be written as follows:
- “Digital breast tomosynthesis/3D mammogram if available; if mammographically dense tissue, then perform screening ultrasound.”
It may be possible to create a conditional, contingent order with the imaging facility or Radiology Department, indicating “additional testing permitted,” and/or to work with administration to add supplemental imaging to the electronic ordering system. While supplemental dense breast screening with MRI detects more cancers than ultrasound, such MRI may not be covered by insurance and is more often reserved for those women who are at high risk.Browse All Provider FAQ's