de Paredes listed various risk factors impacting the ability to detect breast cancer on imaging studies.


Factors that may increase the risk of missing a breast cancer:

(1) suboptimal images caused by technical problems

(2) radiologist being tired, inexperienced, sick, distracted, hurried or otherwise impaired

(3) presence of dense stromal fibrosis or other process that obscures the images

(4) lobular carcinoma

(5) a slowly growing tumor that does not change in size

(6) failure to look at all necessary views

(7) failure to perform additional studies that may be indicated

(8) tumor in a location that is hard to visualize

(9) radiologist making a wrong assumption

(10) failure to complete a thorough review of all material, especially when more than one abnormality is present


Factors that may decrease the risk of missing a breast cancer:

(1) having each imaging study double read or reviewed by a computer

(2) being meticulous and thorough

(3) comparing every imaging study with any previous images

(4) having a high quality control program

(5) following up any suspicious finding


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