How to avoid malpractice in breast imaging

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Published: 6 Feb 2023
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Prof Merit El Maadawy - Mansoura University School of Medicine, Mansoura, Egypt

Prof Merit El Maadawy speaks to ecancer about how to avoid malpractice in breast imaging. 

She highlights that the mistake of not providing patients with standard-of-care can lead to mistakes further down the course of treatment. Breast imaging mistakes could mean more aggressive surgery and a lower survival rate.

Communication and auditing are two major points Prof El.Maadawy explores. This allows radiologists to assess the performance accordingly and correctly.

My talk was about malpractice which is when we fail to appropriately provide our patients with the appropriate standard of care. I was highlighting for especially the young radiologists the mistakes that can lead to this style of practice. Especially in our field, the breast imaging field, mistakes lead to either missing a cancer, which is very harmful of course, or may delay the diagnosis which also may delay the treatment for our patients. That means it’s a more aggressive surgery and treatment and lowers the survival rate chance.

It’s some key words that are related to this malpractice. Some of them lead to this style of practice like, for example, when we are not obtaining enough data, clinical data, that’s mainly an appropriate next step for our patient. Also, another key word is reviewing the previous images and the previous studies of our patient so we can come to the conclusion to what is an appropriate next step. Communication is a very important part that not many pay attention to and it leads to mistakes and malpractice. Communication of the radiologist with the patient, with also the physician and the rest of the team, is a very important point to come all of us like a team with appropriate next steps for our patient.

Also, I highlighted a very important point which is another thing, it’s the way that we, as a radiologist, assess our performance and check if we are getting enough cancer detected or if we are doing overdiagnosis, like doing more biopsies than necessary. This is how other things can help radiologists to assess their performance and accordingly they can see how they can enhance this performance by different ways. For example, one of the important ways is double reading where a lot of institutes get each mammogram to be read twice, so to make sure no more cancers are missed. 

The other thing is when we established there is a breast imaging society, one of our main goals was to put in Egypt a unified standard of care regarding early detection and mammography and ensure that Egyptian women get access to the early detection programmes. We are still in the phase of establishing but we are very hopeful to have it sooner because in North America they have the Mammography Quality Act which ensures the quality of early detection and mammograms are optimum for early detection of the cancer for our patients.