Missed Breast Cancers in Mammography


Radiologist, MD Tehran, ICR 2023



Mammography is the standard of reference for the detection of breast carcinoma, yet 10%–30% of breast cancers may be missed at mammography. Missedbreastcancersarebreastmalignancies that are detectable at retrospective review of a previously obtained mammogram that was prospectively reported as showing negative, benign, or probably benign findings. Medical errors are a substantial cause of morbidity and mortality and the third leading cause of death in the United States. Errors resulting in missed breast cancer are the most common reason for medical malpractice lawsuits against all physicians Possible causes for missed breast cancers include dense parenchyma obscuring a lesion, poor positioning or technique, incorrect interpretation of a suspect finding, subtle features of malignancy. The most commonly missed and misinterpreted lesions are stable lesions, benign appearing masses, one-view findings, developing asymmetries, subtle calcifications, and architectural distortion. The various cognitive processes can lead to unconscious bias in breast imaging that result in missed breast cancers, such as satisfaction of search, in attention blindness, premature closing, and satisfaction of reporting. In this presentation it is tried to show some examples of either of the above mammographic features based on the RSNA July august 2020 and RSNA 2003 and also some of our real cases in private practice in order to have some minimization strategies in each of the commonly missed and /or misinterpreted breast lesions, as well as, reducing the more common cognitive biases in breast imaging.