Establishing a histologic basis for false-negative mammograms.
In order to explore the histology of false-negative mammograms, 264 consecutive patients with breast cancer were retrospectively reviewed until 100 patients with palpable cancers were identified. These patients were imaged by a dedicated mammographer within 6 months prior to biopsy. Nine of the 100 patients had "negative" readings originally, with 6 of the 9 still regarded as negative when re-examined after full knowledge of the tumor location. Histologic review of these six tumors showed a diffusely infiltrative pattern in five patients (three with invasive lobular carcinomas and two with multifocal, invasive ductal carcinomas). Although background breast density always serves in a critical relationship with tumor density on film, only one of these six patients showed a severe degree of mammographic breast density. Diffuse histology should be recognized as a principal cause of false-negative mammograms. Since mammography is based solely on anatomic contrasts, diffuse histology could easily prevent the perfection of this modality, calling attention to the need for improved adjunct imaging techniques.
Hollingsworth
A B
AB
Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
Taylor
L D
LD
Rhodes
D C
DC
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000592:standards*; D008875:Middle Aged; D012189:Retrospective Studies