Medico-legal issues in breast imaging

Objective

To identify medicolegal 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.

Methods

A retrospective study was undertaken and records of 40 medicolegal investigations over a 4-year period were examined (January 2004 to December 2007). The reports were compiled by two consultant breast radiologists who are recognised experts in the field of breast diagnosis.

Results

Thirty per cent of the patients in this study were <40 years of age. The most common complaint in this series was a delay in diagnosis (90%). The mean average delay in diagnosis was 17.3 months. Substandard care was cited in 60% cases, of which 66% was considered the fault of the radiologist involved. Of these cases 67% of mammograms were reported as normal or of benign features, with microcalcification being the most common mammo-graphic sign to be missed or misinterpreted (75%).

Conclusion

The commonest complaint is delay in diagnosis. Complaints are more common in the younger age group, consistent with the previous American Breast Cancer Study [1]. Microcalcification was the commonest sign in cases where there was incorrect interpretation of the radiology.