Doctors Advise Women to Question Mammography Machines

When the doctor said the word “cancer,” Claudia Batts couldn’t believe it.  She had no prior indication there was a tumor growing in her breast. 

"I felt fine. I could not feel a lump. I didn’t have any pain, nothing," the Dallas woman said, recalling the day she was diagnosed.

Ten years ago, Batts' cancer was found by a routine mammogram.  She is now cancer free because doctors caught the cancer early, at its most treatable stage.

"Mammograms are so important," Batts said. "Early detection is good."

Because mammograms can mean life or death, the Texas Department of Health Services inspects every mammogram facility in the state at least once a year.  Inspectors check to make sure the staff has proper training and that the machines that take and process the images are working correctly so doctors can see even the smallest cancers.

Dr. Mark Fulmer, a breast radiologist at the Baylor Cass Breast Imaging Center, said the state regulations and inspections are crucial for patient safety. 

"If any of those criteria aren’t met, the risk to the patient is there will be a cancer that someone won’t see," Fulmer said

Through an open records request, NBC 5 obtained the most recent inspection reports for mammogram facilities in North Texas.  The reports provide an inside look at how local mammogram centers are doing when it comes to following the rules designed to keep patients safe.

The state of Texas codes violations in four ways when inspecting facilities.  Level I, the most serious, through Level IV,  the least serious.

The good news for doctors and patients: there were no Level I violations found during the most recent inspections at any of the 88 facilities visited in North Texas.

However, inspectors did find Level II violations at 16 mammogram centers. A Level II violation means that the facility was "generally acceptable" but that inspectors identified at least one item that "may compromise the quality of mammography services."

For example: According to a state inspection report, in July of 2008 inspectors found that the Dallas Regional Medical Center in Mesquite "failed to perform or analyze ... quality control items" on mammogram machines and processing equipment. 

Those quality control tests are designed to make sure the machines can spot a tumor. 

After the state found the violations, hospital spokeswoman Paula Risedorfer said the hospital quickly corrected the problem.

"We took immediate action and the violations were resolved,” said Risedorfer.

The hospital is now in compliance with the state regulations, according to a follow-up letter issued by the state.

At a Solis Women’s Health location in Arlington, the state found that the center "failed to apply for ... Texas certification for Mammography" for one of it's x-ray units, according to a state report issued in November. 

State records show the machine in question was used for "85 days on 121 patients". 

Solis Women’s Health’s COO, Bonnie Lankford described the issue as a paperwork oversight and said, "absolutely no quality of care was compromised." 

When state inspectors ultimately checked the machine, it was working properly, and the center is now in compliance. 

Solis operates mammogram centers across North Texas and the Arlington location was the only one to receive a Level II violation in its most recent state check.

There is an easy way for patients to check to see if a mammogram center has passed state inspection without any significant violations.  The state issues a “Certificate of Inspection” only to facilities that pass without any Level I, II, or III violations.

Patients can ask to see the certificate of inspection at a mammogram center, and many centers that have earned one display it on their walls.  A state letter that accompanies the inspection certificate indicates it is awarded only to "those facilities that are clearly above the average in comparison with their peers."

Dr. John Pippen, an oncologist and a spokesman for the American Cancer Society, said it’s important for patients to ask questions of mammogram facilities.

"It’s very reasonable for a patient to ask about the quality of the films they’re going to have at an imaging center.  Ask about accreditation, ask a few questions of the doctor because so much is at stake here," said Pippen.

Batts knows that first hand.  She now runs a cancer support group and encourages other women to get a yearly mammogram.  She tells them, "early detection means a lot."

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