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Analysis of patients with false negative mammography and symptomatic breast carcinoma
Author(s) -
Murphy Ian G.,
Dillon Mary F.,
Doherty Ann O',
McDermott Enda W.,
Kelly Gabrielle,
O'Higgins Niall,
Hill Arnold D.K.
Publication year - 2007
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20801
Subject(s) - medicine , mammography , carcinoma , breast carcinoma , radiology , oncology , general surgery , gynecology , breast cancer , cancer
Aim False‐negative mammograms may result in a delay in breast carcinoma diagnosis and have important implications for patient care. In this study, the characteristics of symptomatic patients with false‐negative mammograms were analysed. Methods Patients with symptomatic breast carcinoma were identified over a 10‐year period (1994–2004). One hundred and twenty‐four patients had false‐negative preoperative mammograms and 1241 patients had abnormal preoperative mammograms. Clinical presentation, diagnostic methods and pathology were analysed. False‐negative mammograms were reviewed by a specialist breast radiologist. Results Following retrospective review, 42% of false‐negative mammograms were re‐categorised as suspicious. The most commonly misinterpreted lesion was architectural distortion/asymmetrical density. Adjuvant ultrasound, where performed (n = 27), raised the level of suspicion in 93% of cases. Patients with false‐negative mammograms were more likely to be younger ( P < 0.0001), present with nipple discharge ( P = 0.002) and have smaller tumours ( P < 0.0001). Their tumours were more frequently located outside the upper outer quadrant ( P = 0.002). False‐negative mammography led to a delay in diagnosis of >2 months in 12 patients. Conclusion Symptomatic patients with false‐negative mammograms often demonstrate definite abnormalities on imaging, the most common of which is architectural distortion/asymmetrical density. Those at particular risk were younger patients, those with nipple discharge, and patients with lesions located outside the upper outer quadrant. J. Surg. Oncol. 2007;96:457–463. © 2007 Wiley‐Liss, Inc.