Hema Nandini Purushothaman, Presenter: Nothing to Disclose

Juliet Claire Morel, Abstract Co-Author: Nothing to Disclose

Lisa Marie Meacock MBBS, Abstract Co-Author: Nothing to Disclose

Elizabeth Anne Maxine O'Flynn MBBS, Abstract Co-Author: Nothing to Disclose

Robin Wilson FRCR, Abstract Co-Author: Nothing to Disclose

Michael J. Michell MBBCH, Abstract Co-Author: Nothing to Disclose

To identify common medico-legal issues that occur in the diagnosis and radiological management of breast disease. To propose measures to reduce the risk of patient complaints and legal action in breast radiology and diagnosis.

A retrospective study was undertaken and the records of 64 medico-legal investigations over a 4 year period were examined (January 2004 to December 2007). The reports were compiled by 2 Consultant Breast Radiologists who are recognised experts in the field of breast diagnosis.

30% of the patients who were represented in this study were <40 years of age. The main complaint was a delay in diagnosis (94%) followed by inappropriate or inadequate treatment. The mean average delay in diagnosis was 17.2 months. 88% of cases were patients that had presented to the symptomatic clinic, 12% had come through screening assessment clinic. The main presenting symptom was a palpable lump (66%) followed by nipple inversion. Substandard care was cited in 47% cases, of which 73% was considered the fault of the radiologist and 13% considered the fault of the breast surgeon. Of the cases where the radiologist was considered at fault, microcalcification was the most common mammographic sign to be missed or misinterpreted (12 out of 22 cases: 55%) followed by distortion (6 out of 22 cases: 28%).  

The commonest complaint in this series is delay in diagnosis with microcalcification being the main mammographic sign that is either not seen or misinterpreted. Complaints are more common in the younger age group consistent with the previous American Breast Cancer Study.1  1 PIAA Breast Cancer Study June 1995.  

Delay in diagnosis is the most common medico-legal issue in the management of breast disease. This study helps us to identify the main complaints with an aim to reduce legal action.

Purushothaman, H, Morel, J, Meacock, L, O'Flynn, E, Wilson, R, Michell, M, Medico-legal Issues in Breast Imaging.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6011923.html