Breast Imaging During COVID-19 FAQ

You had questions. We have answers.

During the second installation of the Genius Sessions, A Peer-to-Peer Discussion about Breast Imaging During a Pandemic, participants submitted questions around reestablishing breast health services in light of the COVID-19 pandemic as well as patient sentiment. See our esteemed panelists’ responses below. View our patient survey findings.

Dr. Sarah Friedewald, MD, FSBI

Vice Chair of Clinical Operations and Women's Imaging and Medical Director of the Lynn Sage Breast Center Northwestern Memorial Hospital

Dr. Regina Hooley, MD, FSBI

Interim Breast Imaging Division Chief, Professor & Vice Chair for Clinical Affairs, Radiology & Biomedical Imaging, Yale School of Medicine

Dr. Stamatia Destounis, MD, FACR, FSBI, FAIUM

Partner Radiologist, Elizabeth Wende Breast Care, Clinical Professor University of Rochester Imaging Sciences

List current screening mammography PPE - for patients

Not performing screening.
-Dr. Friedewald

Mask - all patients either wear their own or are given a mask upon entry to hospital/clinic.
-Dr. Hooley

All patients wear surgical masks.
-Dr. Destounis

List current screening mammography PPE - for staff

Not performing screening.
-Dr. Friedewald

Techs - surgical mask, plus faceshield & yellow gown (mammo tech). But now yellow gowns are in short supply so we are looking into atlernatives - paper surgical clothes , which are single use and changed betewen pts or a lab coat for techs that are washed at the end of the day. Radiologists were surgical masks to speak to patients. N95+ faceshield plus yellow gown for procedures.
-Dr. Hooley

Technologists wear surgical mask and gloves. All other staff wear surgical masks.
-Dr. Destounis

Any change in patient PPE for diagnostics?

Just masks.
-Dr. Friedewald

No.
-Dr. Hooley

Every patient wears a surgical mask.
-Dr. Destounis

Any change in staff PPE for diagnostics?

Just masks.
-Dr. Friedewald

No.
-Dr. Hooley

Surgical masks and gloves for ultrasound exams.
-Dr. Destounis

How often are masks being changed?

For staff, for as long as they can keep it, up to 1 week.
-Dr. Friedewald

Daily - they are recycled by hospital, so we can't wear makeup since that soils PPE and can't recyle. Faceshields are wiped down between pts and recyled at end of day.
-Dr. Hooley

Every 8 hour shift unless soiled.
-Dr. Destounis

Does PPE change if patient is Covid positive?

We don't see COVID positive patients unless they are at least 14 days since onset of symptoms
-Dr. Friedewald

Techs would wear N95 for the exam. Currently, we would not do any exams/procedures for anyone known COVID positive.
-Dr. Hooley

If patient is known COVID positive we do not see them as we are an outpatient facility and prescreen everyone - staff and patients multiple times prior to arrival at facility
-Dr. Destounis

Are you temperature checking staff? If yes, how?

All staff, at entry into the hospital by a camera with the temperature hovering over the staff's head (real time).
-Dr. Friedewald

Yes, upon entry with strips.
-Dr. Hooley

Honor system staff sign document with questions recommended by CDC before starting work.
-Dr. Destounis

Where are patients changing?

In mammogram room/ultrasound room.
-Dr. Friedewald

In the exam room. We will avoid using lockers and will give patients bags for their clothes.
-Dr. Hooley

In the mammo rooms.
-Dr. Destounis

Have appointment times increased?

Not for diagnostics.
-Dr. Friedewald

Yes, doubling appointment times. 2 diags/hour.
-Dr. Hooley

Yes to avoid any pts sitting together in waiting rooms.
-Dr. Destounis

Is anyone doing proactive Covid testing (staff and patients)?

No pro-active testing.
-Dr. Friedewald

Not yet, but there are plans to implement this over the next few months.
-Dr. Hooley

Not currently in our region.
-Dr. Destounis

Has room cleaning changed at all?

No change.
-Dr. Friedewald

For outpatients, we are looking into expanded "wet cleaning" between patients - using purple wipes to clean all surfaces including door handles and counters.
-Dr. Hooley

Yes deep cleaning all surfaces that patient may come in contact with, multiple times a day, (specific person doing that all day) cleaning the mammo unit in between pts.
-Dr. Destounis

How are you managing increased anxiety with staff?

Daily huddles at 8:15 am by phone/conference call to update on all issues.
-Dr. Friedewald

Tech staff - generally doing ok as there are no furloughs and all staff received a bonus from the hosptial for their fronline work! But in Breast Imaging we always advocate for appropriate PPE and are considering following a model of "universal COVID precautions", which means that we will assume that everyone is positive. Hosptial is plannig on regularly testing all staff soon.
-Dr. Hooley

Staff feel safe with deep cleaning all day and the fact we check patients and staff before they come into facility and all the safety measures we have taken
-Dr. Destounis

How are you managing increased anxiety with patients?

Demonstrating clean technique and reassurance.
-Dr. Friedewald

Pts regsiter the day before arrival and call from the parking lot when they arrive for their appt. Pts will be greeted by an aid at the COVID screening entry site and walked directly to the exam room. We plan to put extra Purell wipes in patient facing areas so pts can wipe down surfaces if they want (there are Purell wipe dispensers that cannot be stolen!). Also increased communication and marketing to our patients.
-Dr. Hooley

Patients have been fine they understand the process of screening we have now, the safety questions, the change in appt scheduling, no one waits in waiting room, our strict no visitor policy and the social distancing in place.
-Dr. Destounis

Are rads on-site for real time screening interpretations?

No screening yet.
-Dr. Friedewald

We are moving away from real time screening results to decrease waiting room crowding and enhance efficiency. We are implementing more same day biopsy appts following an abnormal diagnostic.
-Dr. Hooley

No real time screening everyone leaves, if they have traveled a long distance choice to sit in car wait for results we will call them.
-Dr. Destounis

Do patients wait outside of the facility versus waiting area?

No, utilizing screening waiting area for more space. Zero visitor policy is strictly enforced.
-Dr. Friedewald

Yes, as described above.
-Dr. Hooley

All patients leave except if live far away then they wait in car for results, or if very anxious but we haven't had any issue with our current change in reading protocols.
-Dr. Destounis