Missed Breast Carcinoma: Pitfalls and Pearls

Aneesa S. Majid, Ellen Shaw de Paredes, Richard D. Doherty, Neil R. Sharma, Xavier Salvador
2003 Radiographics  
Mammography is the standard of reference for the detection of breast carcinoma, yet 10%-30% of breast cancers may be missed at mammography. Possible causes for missed breast cancers include dense parenchyma obscuring a lesion, poor positioning or technique, perception error, incorrect interpretation of a suspect finding, subtle features of malignancy, and slow growth of a lesion. Recent studies have emphasized the use of alternative imaging modalities to detect and diagnose breast carcinoma,
more » ... luding ultrasonography (US), magnetic resonance imaging, and nuclear medicine studies. However, the radiologist can take a number of steps that will significantly enhance the accuracy of image interpretation at mammography and decrease the false-negative rate. These steps include performing diagnostic as well as screening mammography, reviewing clinical data and using US to help assess a palpable or mammographically detected mass, strictly adhering to positioning and technical requirements, being alert to subtle features of breast cancers, comparing recent images with earlier mammograms to look for subtle increases in lesion size, looking for additional lesions when one abnormality is seen, and judging a lesion by its most malignant features. © RSNA, 2003 Abbreviation: CAD ϭ computer-aided detection . Recipient of a Certificate of Merit award and an Excellence in Design award for an education exhibit at the 2001 RSNA scientific assembly.
doi:10.1148/rg.234025083 pmid:12853663 fatcat:icfxggkvxjctrpfwj2fityqrdi