Imaging Findings of Missed Breast Cancer: Retrospective Analysis

Abstract

Screening mammography has been proved to be an effective tool to detect early breast cancers and to decrease mortality. However, the rate of false-negative mammograms has been reported to be still high as 10~30%. Missed breast cancers are cancers that are visible at previous mammograms only retrospectively and can be classified as three types; interval cancers, subsequent screen-detected cancers, and alternative imaging-detected cancers. In a small group, screen-detected abnormalities recalled for further evaluation may be dismissed due to false negative diagnostic assessment, leading to delays in breast cancer diagnosis. Possible causes for missing include perception errors, interpretation errors, and technical errors. Furthermore, every diagnostic examination has inherent limitations. Perception errors are often attributed to combined multiple factors; peripheral lesions, single view abnormalities, subtle findings, distracting lesions, and dense parenchyma obscuring a lesion. To decrease the false negative rate, radiologists should be alert to take additional mammograms and ultrasonography, and should try to improve the image quality and interpretation techniques comparing with the previous imaging, considering the use of computer-aided detection or double reading.