Five Questions With: Dr. Linda Donegan

Dr. Linda Donegan is director of mammography at Rhode Island Medical Imaging Inc., where she specializes in breast imaging and intervention. Donegan is also a clinical assistant professor of diagnostic imaging at the Warren Alpert Medical School of Brown University. 

Donegan discusses the number of Rhode Island women who are getting regular mammograms, RIMI’s recent accreditation as a Breast Imaging Center of Excellence and how technology is helping to increase the mammogram’s cancer-detecting ability. 

PBN: Is there any data specific to Rhode Island on what percentage of women are regularly getting mammograms?

DONEGAN: According to Centers for Disease Control and Prevention data for Rhode Island, between July 2013 and June 2018 more than 75% of women ages 50-64 got mammograms, and an additional 12.5% of women ages 40-49 also got them. It is recommended that all women over age 40 get an annual screening mammogram. Mammograms can detect cancer up to two years before it can be felt by a patient or her doctor.

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PBN: Can the state do anything better in terms of accessibility to mammograms?

DONEGAN: Rhode Island Medical Imaging works with the Rhode Island Department of Health on several public health initiatives. RIMI works in partnership with RIDOH’s Women’s Cancer Screening Program to offer patients breast cancer screenings, as well as follow-up services to uninsured or underinsured women who live in Rhode Island.

Women with a high deductible or copay related to these procedures who cannot afford them, or if their health insurance has denied them coverage, can contact the Women’s Cancer Screening Program at 401-222-4324.

PBN: Rhode Island Medical Imaging recently earned accreditation from the American College of Radiology as a Breast Imaging Center of Excellence. What requirements did you have to fulfill to earn that title, and will patients see any change in your services as a result of it?

DONEGAN: The American College of Radiology named RIMI one of the first outpatient diagnostic imaging Centers of Excellence in the country and the first in Rhode Island. This summer we were additionally named a Breast Imaging COE. The Breast Imaging COE designation in particular refers to specialized breast health services, including mammogram, stereotactic breast biopsy, breast MRI and breast ultrasound, including ultrasound-guided breast biopsy.

The rigorous COE process takes these accreditations to a much higher level, setting benchmarks for superior quality in both imaging services and patient-focused care. It signals to our patients they are receiving the highest level of care, from the latest imaging technologies and best practices to RIMI’s team of radiologists who are specially trained to read breast imaging. This is all to ensure that patients receive the most accurate imaging result possible, leading to the best possible health care for them.

PBN: What can health care providers do to encourage more women to have routine mammograms?

DONEGAN: We just celebrated October as Breast Cancer Awareness Month. Its annual occurrence helps increase attention and support for the awareness, early detection and treatment of this disease. Breast cancer is the second-leading cause of cancer death in women, surpassed only by lung cancer. A woman has a 1-in-8 chance of being diagnosed with breast cancer in her lifetime. And most women diagnosed with breast cancer do not have a family history of the disease.

The good news is a recent report from the American Cancer Society has found that death rates from breast cancer in the U.S. have dropped 40% between 1989 and 2017. The overall decline during this time can be attributed to both improvements in treatment and early detection by mammograms. Breast cancer awareness, education and support [all year long] encourages women to get mammograms – and can quite literally save their lives.

PBN: Is there any current technology that is impacting mammograms now, or will in the near future?

DONEGAN: 3D mammography, also known as tomosynthesis, is the latest in breast-imaging technology. It uses a series of X-rays of the breast from different angles and then creates a three-dimensional image of the breast. Women with dense breast tissue are likely to benefit the most from this technology. Radiologists view the breast as thin slices with a 3D mammogram and can better differentiate cancer from other tissue, increasing detection and decreasing “false positives.”

Regardless of the technology used though, women age 40 and older should have an annual mammogram. It is the only test that has been shown in multiple studies to lower a woman’s risk of dying from breast cancer. Mammograms save lives.

Elizabeth Graham is a PBN staff writer. She can be reached at graham@pbn.com.