Ask A Doc – Mammograms, Nurse Navigators and Radiologists

NOCHS Radiologist, Dr. Jeff Stuk, answers your questions about mammography and the medical professionals who can help you at NOCHS.

Q: Do I need a referral for a mammogram?
A: No. Annual mammograms are a covered benefit under Medicare and Medicaid, as well as most commercial insurance plans. Women can and should schedule their own mammograms wherever they choose. Considerations include convenience (close to home or work), the right technology and the right expertise. Another consideration often overlooked is the advantage of having a mammogram performed at, and interpreted by a radiologist, at the same facility, which expedites care.

Q: Is there a difference between hospital-based mammography services and mobile or outpatient screenings?
A: Hospital-based programs provide one-stop, multilevel care that is guided by a core group of experts, who follow the patient. These programs include access to a range of services – in one place — including education, breast exams by trained nurses, screening exams, diagnostic exams/services, breast ultrasound, MRI and image-guided procedures and/or biopsies. Mobile units or screening facilities provide just that, screening. If, during a screening, its discovered that a patient requires additional services, she will have to schedule those services at a later date to happen at a different location, with an entirely new team of clinicians.

Q: What is a Nurse Navigator?
A: Nurse Navigators are the patient’s most important advocate. At NOCHS, outcome data show that nurse navigation has significantly improved breast cancer detection at its Breast Evaluation Center. These clinicians are specially trained in breast health to provide education and perform physical breast exams for all of our screening patients. Navigators also work in the diagnostic phase providing post- biopsy care, as well as consult with the patients to review biopsy results. After a cancer diagnosis, navigators help patients move through a complex medical system. They counsel, coordinate appointments with breast surgeons and oncologists, and generally become the “point person” for patients when questions arise and direction is needed.

Q: What is the Radiologist’s role?
A: Breast imaging radiologists are also specially trained to carefully interpret mammograms and other diagnostic studies, and then make recommendations for next steps, if needed. Within hospital-based programs, where the radiologists are working in the facility (vs. remotely) they are able to join the nurse navigators to deliver a cancer diagnosis allowing patients the opportunity to ask questions. Above and beyond direct patient care, the on-site radiologists are also responsible to ensure patients receive the highest quality exam by adhering to protocols from national standards and overseeing the maintenance of facility certifications.

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