Breast asymmetry - interpretation pitfall

Discussion:

This case illustrates how you have to interpret the images you have and at the same time consider the actual positioning of the breast to explain what you see. The medial tilt of the left breast on the CC view of 2012 is immediately obvious to the trained eye. In fact, no experienced mammography technologist would pass that image as acceptable.

If you were the reader in 2012 you would have re-done the left CC view because it is not technically acceptable. Do not be tempted to read a study that has a suboptimal image. This case proves the point.

In 2013 you would have avoided an unnecessary recall by simply looking back a couple of years. In the analog age, it was a drag to look in the dusty film bag. In the digital age, this is inexcusable.

Unnecessary recalls upset patients and their physicians and devalues the work we do. It's an inconvenience and it costs money and effort.  The recall causes significant stress for the patient and her family. Anecdotally, it seems that once a recall has been done, patients tend to miss their next screening appointment before they resume the normal screening routine. Do not miss cancers but don't recall unnecessarily.

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