Referral Guidelines

The Carol Milgard Breast Center and TRA Medical Imaging have not changed our recommendation that women get yearly screening mammograms every year starting at age 40. If breast cancer is found early, there are more treatment options and a better chance for survival. Women whose breast cancer is detected at an early stage have a 93 percent or higher survival rate in the first five years.

The breast center also recommends women in their 20s should begin regular breast self-examinations to understand what looks and feels normal for their breasts, and should also start to receive regular clinical breast exams by a health care provider.

Breast Imaging Referral Guidelines

Female

Screening Mammogram

Patient is asymptomatic or has no focal/persistent symptoms
Annually starting at age 40
Baseline screening acceptable at age 35 (written referral required for patients under 40)
Patients with increased risk—positive for BRCA 1 or 2 genes or have 1st degree relatives (mother, sister, daughter) with a history of breast cancer or with proven BRCA mutations—should have an annual screening mammogram from age 30

Diagnostic Mammogram

Definition of symptoms: lump, thickening, palpable abnormality, unusual nipple discharge, skin or nipple retraction/change, or any pain that is not chronic or cyclical

Patients age 30 or older presenting with symptoms should have a bilateral diagnostic mammogram; possible ultrasound to follow
Patients age 30 or older presenting with a new symptom, if more than 3 months after their last mammogram should have a unilateral diagnostic mammogram; possible ultrasound to follow
Patients with history of breast cancer should have a diagnostic mammogram every 6 months for 2 years following initial diagnosis; then an annual diagnostic mammogram for the next three years; then return to annual screening mammogram.

Breast Ultrasound

Patients under the age of 30 presenting with new symptoms; possible diagnostic mammogram to follow
Patients who are nursing or stopped nursing less than 6 months ago presenting with new symptoms
Patients who are pregnant presenting with new symptoms; possible diagnostic mammogram to follow

Male

Diagnostic Mammogram

Definition of symptoms: lump, swelling, nipple discharge or pain

Patients 20 years of age or older presenting with symptoms; possible ultrasound to follow
Learn more about breast disease in men.

Adolescents

Patients 12 years of age or older presenting with symptoms (lump, swelling, nipple discharge or pain) should have an ultrasound performed first
Patients under the age of 12 can be evaluated by a pediatrician and pediatric radiologist
There are other special circumstances which are not outlined here (i.e. patient with history of chest radiation or patient with first degree family member diagnosed early with breast cancer).

Please contact our office at (253) 759-2622 and press 1 to consult with a radiologist who specializes is breast imaging about your patient.