What is a mammographer?
Before discussing salary issues, we should first define which field and specialists we are talking about. Mammographers are diagnostic radiologists who are fellowship-trained in imaging of the breast. Some centers are moving away from the name of 'mammography' towards the broader field of women's imaging, which would include imaging of the female genitourinary tract, as well as have a broader role in patient care, specifically women's health issues. Regardless, the main focus would still remain on diagnosing and intervening on disease of the breast using various imaging modalities. The main modality is, of course, a mammogram, which uses intense radiation beams in special machines at various planes to produce 2-D images of the breast. However, new imaging including MRI and musculoskeletal radiology are opening new avenues for imaging of the breast. Some programs now offer a combined mammography/musculoskeletal fellowship for radiology residents interested in pursuing the cutting edge in mammography.
In addition to diagnosing lesions of the breast, mammographers are involved in biopsying such lesions through stereotactic biopsies, in which the biopsy is performed via large bore needles in the radiology suites instead of in an operating room. Furthermore, a mammographer may be heavily involved in patient care, as the mammographer often may be the first physician to inform a patient of a suspicious breast lesion which may turn out to be cancerous. Such a diagnosis can have a huge impact on a patient's life, even if the lesion eventually turns out to be benign. Given the gravity of the situation, it is important for mammographers to be fully trained to deal with all the dimensions of their job.
Why is mammography making a comeback?
A few years ago, litigation posed a serious threat to mammography. A mammogram is a screening tool, but it offers no guarantee of preventing breast cancer. Sometimes, unfortunately, women would receive regular mammograms and still receive a diagnosis of advanced breast cancer. There is no way for the mammographer to prevent this unfortunate combination of circumstance and genetics. However, a subset of these patients would involve a lawyer. Once a lesion has been diagnosed, it is easy for a lawyer to look back at old mammograms and highlight the suspicious area and ask of the mammographer why more was not done at an earlier time. This approach utilizes a logical fallacy which can be easily summarized as "hindsight 20/20." In reality, there are many suspicious lesions on mammograms, but working up every questionable spot on a mammogram would lead to more harm than good, so the mammographer must be judicious in following questionable areas, with the risk that sometimes this conservative approach more produce more harm in a particular individual.
Some states have realized that this puts the mammographer in an untenable positions. By instituting tort reform, they do not free the mammographer of liability but rather acknowledge that such errors are not born out of malice but rather are a function of the system we inhabit. This reform has helped mammographers function more appropriately, thus increasing demand for the field. According to the Centers for Medicare Services, mammographers are one of the highest compensated medical specialities as of 2008:
Diagnostic Radiology - M.D.s Interventional - $463,219
Diagnostic Radiology - M.D.s Neuro-Interventional - $500,000
Diagnostic Radiology - M.D.s Non-Interventional - $420,858
Mammography - $540,028
Nuclear Medicine (M.D.s Only) - $331,866
Radiation Therapy (M.D.s Only) - $395,166Source: http://www.cms.hhs.gov/AcuteInpatientPPS/Downloads/AMGA_08_data.pdf
Given this data, if you were considering mammography before but were unsure of the future of the field, give it another look. You might be surprised by what you find.