Use of Comparison Films for Breast Cancer Screening and Diagnosis Among Florida Radiologists

Abstract

Background: In the United States, there are on average, 200,000 cases of breast cancer diagnosed each year. Research studies conducted by the National Cancer Institute have estimated that one out of every eight women in the United States (12.5%) will develop breast cancer during her lifetime, with the highest percentage of women diagnosed between ages 40 and 50. Due to the good prognosis of early detection, much research has recently surfaced on the efficacy of diagnostic testing of cancerous breast tissue. However, research has shown that up to 4% of breast cancers are missed, and a major factor is the lack of comparison mammogram. Methods: A one page anonymous survey was sent to licensed Florida Radiologists using randomization provided by Medical Marketing Services, Inc (MMS). The number of radiologists registered within the MMS database in the state of Florida is 98. A number of surveys were also sent to radiologists working within the Memorial Healthcare System of Broward County, FL. The total number of responses collected was 22. Results: According to the collected data, forty-one percent of Florida radiologists review mammograms in their practice. Twenty-three percent of radiologists review mammograms more than half the time, while eighteen percent review mammograms less than half the time. Of the Florida radiologists who review mammograms, ninety-five percent believe that comparing past mammograms is very important in making a correct diagnosis. However, twenty-two percent of those radiologists never compare past films. Twenty-four percent of Florida radiologists reading mammograms have been sued for malpractice at least one time. There is a strong inverse relationship between comparing mammograms and likelihood to be sued. Florida radiologists who think comparing mammograms is “very important” were less likely to be sued for malpractice (R = 0.99, p < 0.0001). Conclusions: The objective of the study was to establish a relationship between mammogram comparison and misdiagnosis rates of breast cancer. The results show a strong inverse relationship, in that an increase of mammogram comparison will likely decrease the failure to diagnose breast cancer. Since radiologists agree that comparing mammograms is essential, comparison must be emphasized in continuing educational courses and must be made part of routine procedure. Moreover, primary care physicians must educate their patients as to the importance of having past mammograms in their possession so that present and future mammograms can be compared.