Analysis of patients with false negative mammography and symptomatic breast carcinoma
Article first published online: 10 OCT 2007
Copyright © 2007 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 96, Issue 6, pages 457–463, 1 November 2007
How to Cite
Murphy, I. G., Dillon, M. F., Doherty, A. O., McDermott, E. W., Kelly, G., O'Higgins, N. and Hill, A. D.K. (2007), Analysis of patients with false negative mammography and symptomatic breast carcinoma. J. Surg. Oncol., 96: 457–463. doi: 10.1002/jso.20801
- Issue published online: 10 OCT 2007
- Article first published online: 10 OCT 2007
- Manuscript Accepted: 5 FEB 2007
- Manuscript Received: 13 SEP 2006
- breast neoplasm;
- sensitivity and specificity;
- signs and symptoms;
False-negative mammograms may result in a delay in breast carcinoma diagnosis and have important implications for patient care. In this study, the characteristics of symptomatic patients with false-negative mammograms were analysed.
Patients with symptomatic breast carcinoma were identified over a 10-year period (1994–2004). One hundred and twenty-four patients had false-negative preoperative mammograms and 1241 patients had abnormal preoperative mammograms. Clinical presentation, diagnostic methods and pathology were analysed. False-negative mammograms were reviewed by a specialist breast radiologist.
Following retrospective review, 42% of false-negative mammograms were re-categorised as suspicious. The most commonly misinterpreted lesion was architectural distortion/asymmetrical density. Adjuvant ultrasound, where performed (n = 27), raised the level of suspicion in 93% of cases. Patients with false-negative mammograms were more likely to be younger (P < 0.0001), present with nipple discharge (P = 0.002) and have smaller tumours (P < 0.0001). Their tumours were more frequently located outside the upper outer quadrant (P = 0.002). False-negative mammography led to a delay in diagnosis of >2 months in 12 patients.
Symptomatic patients with false-negative mammograms often demonstrate definite abnormalities on imaging, the most common of which is architectural distortion/asymmetrical density. Those at particular risk were younger patients, those with nipple discharge, and patients with lesions located outside the upper outer quadrant. J. Surg. Oncol. 2007;96:457–463. © 2007 Wiley-Liss, Inc.