Volume 14 Supplement 1
False negative assessments: an effective quality assurance method
© Manuel et al.; licensee BioMed Central Ltd. 2012
Published: 9 November 2012
To identify the frequency and characteristics of false negative assessment (FNA); an interval cancer with prior recall to assessment.
A retrospective audit, over 7 years, between 1 April 2004 and 31 March 2011. Using NBSS databases, we recorded: lesion type, size, further mammographic views, ultrasound, clinical findings, biopsy results and final histology.
Twenty-nine cases by QARC, 13 true FNA and 16 excluded because contralateral or in a different quadrant. In this period, 220,522 woman were screened and 10,391 (<5%) were referred for assessment. Total cancers detected in this period were 2,343, of which 1,867 were diagnosed at assessment and 476 (20%) were interval cancers. True FNA: 2.7% of all interval cancers. True FNA: 0.6% of all screen-detected cancers. All cases were background mixed density. True FNA: 11/13 incident screen, 2/13 prevalent. Asymmetry/stromal deformity in 7/13 (54%), calcification 4/13 (30%), mass 2/13 (15%). Two cases were early recall (EC) (asymmetry, and mass with calcifications), both incident screens. EC did not contribute in either case as it led to false reassurance. All asymmetry/stromal deformity reassuring on further views, with no correlating ultrasound or clinical abnormality. On review of all cases, only 2/13 were felt not to have had complete triple assessment. Final pathology: two DCIS, four lobular cancers, seven ductal cancers. Seven cases were discussed at a multidisciplinary meeting.
True FNA remains very low. This is because assessment cases have complete triple assessment and MDT discussion. FNA can be used as a valuable educational process and mechanism to ensure consistency and adherence to NHSBSP standards.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.