Are too many breast cancers missed at assessment?

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The objectives of this study were to ascertain the proportion of interval breast cancers arising after incorrect return to routine 3-year recall following assessment at the screening unit. Two hundred and fifty-six interval cancer cases known to the unit were reviewed; 31 of these women had attended for assessment, seven of which had been recalled for assessment of the contralateral breast and eight for assessment for an apparent abnormality in the same breast, but at a different site to where the interval cancer subsequently developed. The remaining 16 women (6%) had undergone false-negative assessment. Some cancers may have been detected earlier if image-guided FNAC or core biopsy had been included in the assessment of: (1) all solid masses and complex cysts; (2) radiologically suspicious abnormalities, even if unchanged in appearance compared to previous films; (3) areas of stromal deformity thought to be composite if there was associated palpable thickening.