Picture of Wellness : Some experts say women should hold on to copies of base-line mammograms for future use.
Even as the medical community continues to debate the issue of just how valuable base-line mammograms may be and how early women should start regu larly getting mammograms, there’s another question to consider: What good is a base-line mammogram if it’s not kept safely somewhere and easily accessible?
Many women assume that the facilities at which they have their mammograms done keep the films indefinitely, and some do. But others have policies to retain the films for only five to 12 years. That means that the chances are--just when a doctor suggests that looking at a base-line film might be helpful--it could be gone, off to a landfill to make room for other, more recent films.
How long a facility keeps the films varies from place to place. Dr. Parvis Gamagami, radiologist at the Breast Center in Van Nuys, says his center has kept all the mammography films it has done since it opened 13 years ago, and plans to continue to retain them.
At Kaiser Permanente Medical Center in Woodland Hills, John Hunt, administrator of diagnostic imaging, says mammography films are kept five years at the Woodland Hills site, then are sent to a storage center for an additional seven years, after which they are destroyed. The legal standard, according to Hunt, is to keep all X-ray films for a minimum of seven years.
Hunt says tracking down old films from other facilities can be difficult, however, often taking weeks or months from the time that the physician first requests them.
That’s why some experts recommend that women, especially those moving out of town or changing health care providers, get copies of their mammograms to ensure that the films are easily and quickly available in case they are needed. “Especially if the patient has a family history of breast cancer, or a history of multiple breast nodules or surgery, it’s good to have the mammogram films on hand,” Gamagami says.
By state law in California, facilities must provide copies of medical records, X-rays and tracings--which include mammograms--within 15 calendar days, said Laurie Holoff, director of medical records at Northridge Hospital Medical Center. Most other states have no such requirement, Holoff said.
The jury is still out on how valuable a base-line mammogram will be if symptoms should appear. Although the American College of Obstetricians and Gynecologists recommends mammograms every one to two years for women 40 to 50, and annually for women older than 50, other experts question the value of films taken years before a problem developed.
Dr. Susan Love, director of the UCLA Breast Center, says base-line mammograms are often not as clinically useful because a woman’s breast tissue typically changes over time. “What you want is to compare to the previous year or two,” she said.
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Yet some still value the base-line film, saying it gives the physician a frame of reference from which to assess changes in the breast tissue pattern, Gamagami says. “It’s helpful to be able to go back to the base-line film and study it,” he says.
There are downsides to getting your own mammogram copies. If films are not stored properly, they may be worthless. Hunt says one woman who requested her films immediately plopped them into the trunk of her car, exposing them to heat that probably ruined them.
“We think the films are best protected and safer kept in the facilities where they were taken,” Gamagami says. But storing the films appropriately is not all that difficult. They need to be kept flat, away from light or heat, at about 70 to 75 degrees Fahrenheit, Gamagami says. And if something should happen to the copies, the facility may still have the originals.
Most places charge for mammogram copies--even though technically the films are the property of the patient.
Kaiser, for example, requires a clerical fee of $12 and a copying charge of $5 per film. Kaiser keeps the original and gives the patient the copy to keep.
Patients are asked to sign a printed release form, which verifies that they have received the films.
Patty McCaleb, 39, was moving from Thousand Oaks to Paradise Valley, Ariz., and wanted to be sure that she always had access to both her base-line mammogram and another done just before she left the Los Angeles area. So for about $22, she bought copies, which she plans to store in her closet.
For McCaleb, getting the copies is an effort to hedge her bets, in case a quick interpretation is ever needed.
“The facility had told me they would keep the films indefinitely--unless they ran out of storage,” she says.
Tips for Getting Copies
For many women, the best bet may be to let the facility that did the mammogram keep the films until they are needed. But for others--especially those who are moving, or who are at greater risk for needing quick access to a base-line film--having a copy could be a good idea. Here are some tips:
* Find out how long the facility keeps mammograms. Ask about the center’s policy on providing mammogram copies and what the charges are, if any.
* If you plan to move, or switch physicians or mammography centers, consider getting copies of your films, or have them sent to your new facility.
* The recently passed federal Mammography Quality Standards Act requires that all facilities be government-certified and inspected. For a list of centers in your neighborhood that are accredited, call the National Cancer Institute’s Cancer Information Services line in Los Angeles at (800) 4-CANCER.
