Abstract
AIM: To identify medico-legal issues that occur in the diagnosis and radiological management of breast disease and to propose measures to reduce the risk of patient complaints and legal action in breast radiology and diagnosis. MATERIALS AND METHODS: Institutional review board approval was not applicable for this study. A retrospective study was undertaken and records of 120 medico-legal investigations over a 10 year period were examined. The reports were compiled by two consultant breast radiologists. RESULTS: The mean age of the patients represented in this study was 48.3 years. The main complaint in this series was a delay in diagnosis (92%) followed by inappropriate or inadequate treatment (8%). 81% of cases were patients who had presented to the symptomatic clinic. The main presenting symptom was a palpable lump (65%). Substandard care was cited in 49/120 cases (41%). The mean average delay in diagnosis was 15.6 months. Of the cases cited as substandard care, 61% were considered the fault of the radiologist and 14% considered the fault of the breast surgeon. Of the cases where the radiologist was considered to be at fault, microcalcification was the most common mammographic sign to be missed or misinterpreted (12/26 cases, 46%). CONCLUSION: The most common complaint in this series was delay in diagnosis with microcalcification being the main mammographic sign that was either not seen or misinterpreted by the radiologist. Clear and precise written protocols are recommended for all breast imaging practice to ensure that medico-legal investigations will be greatly reduced. (C) 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Highlights
Breast-sparing oncoplastic procedures (BSOP) offer a predictive marker guiding use of anti-oestrogen therapy, and radical new alternative to mastectomy and conventional breast- expression profiling appears to select patients more or less likely to conserving surgery in early breast cancer treatment
The aim was to document attitudes to male radiographers and the effect on the programme performance parameters through a postal questionnaire completed by 85.8% of a random sample of 2,000 women recently screened by BreastCheck
Nine per cent would not have proceeded if the radiographer was male; 17.5% agreed that ‘If there were male radiographers I would not return for another screening appointment’; and 18.3% were unsure
Summary
Breast-sparing oncoplastic procedures (BSOP) offer a predictive marker guiding use of anti-oestrogen therapy, and radical new alternative to mastectomy and conventional breast- expression profiling appears to select patients more or less likely to conserving surgery in early breast cancer treatment. We have compared the results of screening with analogue and digital technology over our first 2 years, in terms of recall rates, cancer detection rates and positive predictive value, and found no overall significant difference in any of these parameters. Abnormalities are graded as A, B or C at consensus by the radiologists and reporting radiographers depending upon the mammographic likelihood of cancer and biopsy This means that patients can be allocated to one of our three assessment clinics and at specific times within those clinics to facilitate workflow. Methods A retrospective analysis of all breast cancer patients with recurrence who had completed 5 years of follow-up was performed. Infection control is not routinely included in the quality assurance process of all units
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