Unfair comments in the Press About Mammography interpretations

Radiologist's misdiagnosis endangers 17 (Source United Press International)
"At least 17 British women's lives are at risk because a suspended radiologist wrongly told them they were clear of breast cancer, reports said Tuesday. The unnamed doctor -- the only radiologist at Trafford General and North Manchester General in the Manchester, England, area -- was suspended last April based on co-workers' concerns about the accuracy of his diagnoses, Sky News and The Times of London reported. Nearly 2,500 mammograms read by the radiologist since April 2003 were rechecked, 28 of which were misdiagnosed. "

Mammography per se has its own limitations and public should be educated about the possibility of false negative in this test. And so that they develop reasonable expectations of this test or more and more Radiologists will shy away from this test.

Interpretations of mammograms can be difficult because a normal breast can appear differently for each woman. Also, the appearance of an image may be compromised if there is powder or salve on the breasts or if you have undergone breast surgery. Because some breast cancers are hard to visualize, a radiologist may want to compare the image to views from previous examinations. Not all cancers of the breast can be seen on mammography.

Reference- http://www.radiologyinfo.org/content/mammogram.htm#Limits

From the literature-

N J Med. 2005 Jan-Feb;102(1-2):45-9.

"Concerns about screening mammography include questions of efficacy, high recall rates, false positives, and age at which to institute annual screening. Annual screening mammography can decrease breast cancer mortality by 45% in women over fifty and 23% in women between forty and fifty years of age. Patient recall rates and accuracy of interpretation vary among radiologists. Suggestions for improving accuracy of mammographic interpretation include continuing education with emphasis on quality of interpretation, computer-assisted detection, double reading, increased volume per reader, and performance-related skills testing. Having fewer radiologists reading more mammograms may result in decreased patient access to mammography services. Poor reimbursement for mammography and high prevalence of breast cancer-related litigation are disincentives for radiologists to provide mammography services; these issues must be addressed to ensure patient access to mammography. The public must be educated so that reasonable expectations on the benefits and limitations of mammography will develop."