What does H/O (History of) mammogram mean?

Understanding "H/O Mammogram" in Medical Context

"H/O mammogram" refers to a history of mammogram, indicating that a patient has previously undergone mammographic imaging of the breast. This notation is commonly used in medical records to document a patient's prior breast imaging history.

Clinical Significance of H/O Mammogram

Documentation Importance

• H/O mammogram indicates that previous mammographic imaging exists for comparison, which is crucial for radiologists when interpreting current mammograms 1
• Comparison with prior mammograms allows radiologists to identify changes over time that may indicate developing pathology

Surveillance Context

• For patients with a history of breast cancer, H/O mammogram documentation is particularly important as it establishes the surveillance timeline 1, 2
• The American College of Radiology recommends annual mammographic surveillance indefinitely after breast cancer diagnosis 2

Clinical Decision Making

• When reviewing a patient's chart, H/O mammogram prompts clinicians to:
  • Obtain and review previous mammographic results
  • Determine when the last mammogram was performed
  • Assess whether appropriate follow-up occurred for any abnormal findings

Surveillance Protocols Related to H/O Mammogram

Post-Treatment Surveillance

• First post-treatment mammogram should be performed 6-12 months after completing radiation therapy 2
• Subsequent mammograms should be obtained annually if stability of mammographic findings is achieved 1, 2
• Most radiologists recommend transitioning from diagnostic to screening mammography based on time since diagnosis:
  • 79% recommend at least 1 diagnostic mammogram after treatment
  • 49% recommend diagnostic mammography for up to 2 years post-treatment
  • 33% recommend diagnostic mammography for 2-5 years post-treatment 1, 2

Importance of Prior Mammograms

• Mammography detects approximately 91-97% of recurrent DCIS after breast-conserving surgery 1
• The most common presentation of recurrent or second breast cancer is an abnormal mammogram in an otherwise asymptomatic patient 1, 2
• Annual surveillance mammography is associated with reduced breast cancer mortality compared to no surveillance 1, 2

Common Pitfalls in Interpreting H/O Mammogram

Misinterpretation Risks

• 10-30% of breast cancers may be missed on a mammogram 3
• Architectural distortion and non-spiculated high-density masses on prior mammograms may indicate potential malignancies that were initially missed 4

Documentation Errors

• Failure to document H/O mammogram may lead to:
  • Unnecessary duplicate imaging
  • Missed opportunities for comparison with prior studies
  • Delayed diagnosis of subtle progressive changes

Follow-up Failures

• Suboptimal compliance with annual mammography is noted in younger women (<45-50 years), older women (>65 years), African Americans and other minorities, and women without recent physician visits 1, 2
• Stopping mammography surveillance prematurely can lead to missed recurrences, as breast cancer can recur decades after initial diagnosis 2

Best Practices for Managing H/O Mammogram

• Always obtain and review prior mammograms for comparison when interpreting new studies 1
• Document the date and findings of the most recent mammogram in the patient's chart
• Ensure appropriate follow-up for any abnormal findings on previous mammograms
• Maintain consistent surveillance intervals according to guidelines based on the patient's risk factors and history 1, 2

Understanding and properly documenting H/O mammogram is essential for maintaining appropriate breast cancer surveillance and ensuring optimal patient outcomes through early detection of recurrence or new primary breast cancers.