Radiologists' Errors

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Presentation Description

Common radiological errors in interpretation of mammograms leading to missed breast cancers.

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Presentation Transcript

Slide 1: 

Radiologists’ Errors Leading to 1 Missed Breast Cancers

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2 Failure to Properly Position the Patient Radiologist misses the cancerous lesion at the edge of the image. A B A. Side view (mediolateral oblique) of left breast. B. Top view (craniocaudal) of left breast.

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3 Proper Positioning With proper positioning, a cancerous lesion can be seen near the chest wall. A. Side view (mediolateral oblique) of left breast A 2

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4 Failure to Diagnose Multicentric Lesions Observation of the first obvious lesion misleads the radiologist to neglect other lesions. A. Side view (mediolateral oblique) of right breast of 63-year-old woman. First lesion observed Additional lesions missed

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5 Failure to Exert Special Attention In dense breasts, the radiologist must search dilligently for structural distortions. Any abnormalities must be further evaluated with additional views, magnification and ultrasound. Left mediolateral oblique mammogram of 36-year-old woman with dense breasts and palpable mass. Area of palpable mass Pathologic examination revealed invasive, ductal carcinoma. Dense tissue

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6 Failure to Recognize an Evident Lesion To avoid perception error, images should be reviewed as mirror images. This enables the radiologist to recognize asymmetric densities or masses. Bilateral mediolateral oblique mammograms reveal an irregular mass (1) and a subtle structural distortion (2) in right breast.

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7 Failure to Recognize the Subtle Signs of Malignancy A well-circumscribed, lobulated mass of high density – usually benign, is seen in right axillary region. Right lateral mammogram of 63-year-old woman with dense breasts and a nonpalpable mass. Pathologic examination revealed a mucinous carcinoma. Nonpalpable mass

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8 Failure to Recognize the Subtle Signs of Malignancy When asymmetric densities (more evident on mirror image) are associated with calcifications or structural distortions, the risk of malignancy is increased. Biopsy revealed infiltrating lobular carcinoma. Asymmetric density

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9 Slow Growing Malignancy Slow growing, low-grade malignancies are often missed on annual and interval screening mammograms.

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10 Slow Growing Malignancy Right lateral mammogram 8 years later shows growth of lesion. Biopsy revealed tubular carcinoma.

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Summary of 11 Radiologists’ Errors

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End of Presentation

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