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Interpretation of mammogram and ultrasound scans (05HDC11656)

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(05HDC11656, 31 July 2006)

Radiologists ~ Mammogram ~ Ultrasound ~ Breast cancer ~ Screening ~ Breast cyst ~ Calcification

A 42-year-old woman complained about the services provided by a private radiology facility and three radiologists. The woman went to the radiology clinic for a routine mammogram as part of a Well Woman check. The first radiologist identified "simple cysts" in her right breast on the mammogram and asked her to return the following day for an ultrasound scan. The scan and mammogram images were read by two other radiologists, who supported the initial diagnosis and asked the woman to return for follow-up six months later. The follow-up mammogram was also double read. The radiologists concluded that although the cyst had increased in size it was still a simple cyst. Six months later the woman had a further mammogram which showed a mass lesion in the central right breast. An ultrasound guided biopsy was performed, the results of which confirmed that the woman had invasive carcinoma of the breast. She was immediately referred to a breast surgeon and had a radical mastectomy.

It was held that the cancerous changes were not easy to find and that it was not unreasonable for the radiologists to come to the conclusions they did. With the benefit of hindsight, it would have been prudent for the doctors to have aspirated the palpable cyst. However, it is not clear that this would have conclusively diagnosed the presence of cancer. Where doctors act reasonably and, in so doing, miss a diagnosis, their actions are not legally culpable. In these circumstances, the radiologists did not breach the Code.