Misdiagnosis in breast imaging : a statement paper from European Society Breast Imaging (EUSOBI)—Part 2: Main causes of errors in breast imaging and recommendations from European Society of Breast Imaging to limit misdiagnosis

Summary, in English

Importance: Breast cancer is one of the leading causes of negligence claims in radiology. The objective of this document is to describe the specific main causes of errors in breast imaging and provide European Society of Breast Imaging (EUSOBI) recommendations to try to minimize these. Observations: Technical failures represent 17% of all mammographic diagnostic negligence claims. Mammography quality control protocol and dedicated training for technologists and radiologists are essential. Lack of consideration of the clinical context is a second critical issue, as a clinical abnormality is found in 80% of malpractice claims. EUSOBI emphasizes the importance of communication and clinical examination before the diagnostic investigation. Detection errors or misapplications of the lexicon or Breast Imaging Reporting Data System (BI-RADS) score account for 5% of malpractice claims and should be reduced by limiting radiologists’ distraction or fatigue, and being aware of satisfaction of search errors and the importance of a personal systematic review. Errors related to pathological concordance and MDT review can be limited by the use of markers after biopsy and the use of standardized reports, which can aid communication with other specialities. Finally, errors related to tumor or patient factors should be discussed, considering the use of contrast-enhanced mammography and magnetic resonance imaging. Conclusion: Several factors are responsible for misdiagnosis in breast cancer, including errors in the practice of the technician and/or radiologist (technical failures, lack of consideration of the clinical context, incorrect application of the BI-RADS score, false reassurances), lack of communication with other specialists or with the patient, and the type of tumor and breast parenchyma. Key Points: Question What factors most contribute to and what implications stem from misdiagnosis in breast imaging? Findings Ongoing training and education for radiologists and other healthcare providers, as well as interdisciplinary collaboration and communication is paramount. Clinical relevance Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the entire healthcare system.

• Author: Isabelle Thomassin-Naggara; Alexandra Athanasiou; Fleur Kilburn-Toppin; Gabor Forrai; Miruna Ispas; Mihai Lesaru; Elisabetta Giannotti; Katja Pinker-Domenig; Chantal Van Ongeval; Ritse M. Mann; Fiona J. Gilbert; Federica Pediconi; Tamar Sella; Francesco Sardanelli; Rudd Pijnappel; Eva M. Fallenberg; Christiane K. Kuhl; Thomas Helbich; Michael Fuchsjäger; Fiona J. Gilbert; Paola Clauser; Julia Camps Herrero; Pascal Baltzer
• Other contributions: Sophia Zackrisson
• Department/s: LU Profile Area: Light and Materials; LTH Profile Area: Photon Science and Technology; EpiHealth: Epidemiology for Health; Radiology Diagnostics, Malmö
• Publishing year: 2024
• Language: English
• Publication/Series: European Radiology
• Links: http://dx.doi.org/10.1007/s00330-024-11133-4
• Document type: Journal article review
• Publisher: Springer
• Topic: Radiology and Medical Imaging; Cancer and Oncology
• Keywords: Breast cancer; Mammography; Misdiagnosis; MRI; Ultrasonography
• Status: Epub
• Research group: Radiology Diagnostics, Malmö
• ISBN/ISSN/Other: ISSN: 0938-7994