Patient Does Not Recieve Treatment After Suspicious Mammogram Findings

Case Overview

This case takes place in North Dakota and involves a delayed diagnosis in breast cancer. The patient, a female in her mid-sixties, had a mammogram with suspicious findings, so it was recommended that she undergo further workup for possible malignancy. However, the patient was not notified of these findings, and no further workup was done. Fourteen months went by after the initial imaging was done before the patient received appropriate follow-up. The patient underwent a second mammogram which revealed that she had an aggressive tumor. The initial mammogram had revealed tumor of 1 cm or less in size. Fourteen months later, there appeared to be three tumors one of which was over 3 cm.

Questions to the Radiology expert and their responses

Do you perform and interpret mammograms? If so, how often?

I interpret approximately 5000 mammograms per year.

What is the protocol for follow-up of a suspicious mammogram?

The interpreting radiologist and facility have a federally mandated responsibility to inform the patient of their results.

Could a 14 month delay significantly worsen the outcome for a patient with breast cancer?

A 14 month delay in diagnosis is likely to have resulted in a larger tumor at a more advanced stage at the time of diagnosis, which is well known to be associated with a worse prognostic outcome.

About the expert

This board certified expert has been practicing for over 20 years. She completed a fellowship in Breast Imaging at Northwestern University and holds membership in both the Radiological Society of North America and the American Roentgen Ray Society. An invited speaker at national conferences such as the National Diagnostic Imaging Symposium and the Radiological Society of North America Annual Meeting, she has been published in journals such as the World Journal of Radiology and was one of 25 selected national participants for the American Roentgen Ray Society's Clinician Educator Development Program. Currently, this expert is an Assistant Professor of Diagnostic Radiology at a top medical school.