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Review
. 2025 May;35(5):2387-2396.
doi: 10.1007/s00330-024-11128-1. Epub 2024 Nov 15.

Misdiagnosis in breast imaging: a statement paper from European Society Breast Imaging (EUSOBI)-Part 1: The role of common errors in radiology in missed breast cancer and implications of misdiagnosis

Isabelle Thomassin-Naggara  1   2 , Fleur Kilburn-Toppin  3 , Alexandra Athanasiou  4 , Gabor Forrai  5 , Miruna Ispas  6 , Mihai Lesaru  6 , Elisabetta Giannotti  3 , Katja Pinker-Domenig  7   8 , Chantal Van Ongeval  9 , Fiona Gilbert  3 , Ritse M Mann  10   11 , Federica Pediconi  12 ; EUSOBI Board
Collaborators, Affiliations
Review

Misdiagnosis in breast imaging: a statement paper from European Society Breast Imaging (EUSOBI)-Part 1: The role of common errors in radiology in missed breast cancer and implications of misdiagnosis

Isabelle Thomassin-Naggara et al. Eur Radiol. 2025 May.

Abstract

Importance: Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the healthcare system as a whole.

Observations: Some of the potential implications of misdiagnosis in breast imaging include delayed diagnosis or false reassurance, which can result in a delay in treatment and potentially a worse prognosis. Misdiagnosis can also lead to unnecessary procedures, which can cause physical discomfort, anxiety, and emotional distress for patients, as well as increased healthcare costs. All these events can erode patient trust in the healthcare system and in individual healthcare providers. This can have negative implications for patient compliance with screening and treatment recommendations, as well as overall health outcomes. Moreover, misdiagnosis can also result in legal consequences for healthcare providers, including medical malpractice lawsuits and disciplinary action by licensing boards.

Conclusion and relevance: To minimize the risk of misdiagnosis in breast imaging, it is important for healthcare providers to use appropriate imaging techniques and interpret images accurately and consistently. This requires ongoing training and education for radiologists and other healthcare providers, as well as collaboration and communication among healthcare providers to ensure that patients receive appropriate and timely care. If a misdiagnosis does occur, it is important for healthcare providers to communicate with patients and provide appropriate follow-up care to minimize the potential implications of the misdiagnosis. This may include repeat imaging, additional biopsies or other procedures, and referral to specialists for further evaluation and management.

Key points: Question What factors most contribute to and what implications stem from misdiagnosis in breast imaging? Findings Ongoing training and education for radiologists and other healthcare providers, as well as interdisciplinary collaboration and communication, is paramount. Clinical relevance Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the entire healthcare system.

Keywords: Artificial intelligence; MRI; Mammography; Misdiagnosis; Ultrasonography.

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Conflict of interest statement

Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is Isabelle Thomassin-Naggara. Conflict of interest: The authors declare the following disclosures: Isabelle Thomassin-Naggara: speakers bureaus—European Society of Breast Imaging (active), Société d’imagerie de la femme (active), American College of Radiology O-RADS (active), Bayer (ended), Siemens Healthineers (ended), Guerbet (ended), Bard (ended); Ponctual remunerated lectures: GE, Siemens, Guerbet, Hologic, Canon, Guebet, Bracco, GSD, Samsung, Fujifilm, Incepto, ICAD; Research grants: ASCORDIA: ADNEX MR Scoring System: Impact of an MR scoring system on the therapeutic strategy of pelvic adnexal masses PHRC ID RCB 2015-A01593-46. Katia Pinker-Domenig: speakers bureaus—European Society of Breast Imaging (active), Bayer (ended), Siemens Healthineers (ended), DKD 2019 (ended), Olea Medical (ended), Roche (ended), MedScape (ended). Consulting, Advisory: Consultant—Genentech, Inc.: 05/19–present (non-monetary); Consultant—Merantix Healthcare: 05/20–1/2014; Consultant: AURA Health Technologies GmbH: 04/21–2/24; Consultant—Guerbet; 05/2023–1/2024; Consultant—Neodynamics: 12/20223–present. Research grants: Digital Hybrid Breast PET/MRI for Enhanced Diagnosis of Breast Cancer (HYPMED) H2020—Research and Innovation Framework Program PHC-11-2015 #667211-2, A Body Scan for Cancer Detection using Quantum Technology (CANCERSCAN) H2020-FETOPEN # 828978; Multiparametric 18F-Fluoroestradiol PET/MRI coupled with Radiomics Analysis and Machine Learning for Prediction and Assessment of Response to Neoadjuvant Endocrine Therapy in Patients with Hormone Receptor +/HER2 − Invasive Breast Cancer Jubiläumsfonds of the Austrian National Bank # Nr: 18207; Deciphering breast cancer heterogeneity and tackling the hypoxic tumor microenvironment challenge with PET/MRI, MSI and radiomics The Vienna Science and Technology Fund LS19-046; MSKCC 2020 Molecularly Targeted Intra-Operative Imaging Award 07/2020–06/2021, Breast Cancer Research Foundation 06/2019–05/2021; NIH R01 Breast Cancer Intravoxel-Incoherent-Motion MRI Multisite (BRIMM) 09/01/2020–08/30/2025 UG3 CA239861; NIH R01 subaward: Abbreviated Non-Contrast-Enhanced MRI for Breast Cancer Screening 09/01/2023–08/31/2025 R01 CA249893; NIH RO1: Deciphering the Acidic Tumor Environment: A Phase I/IIa Study of Pre-Operative Multiparametric MRI and pHLIP® ICG Intra-Operative Fluorescence Imaging of Primary Breast Cancer 03/01/2023–02/29/2024 1R01CA270018-01A1. Katja Pinker is supported in part through the NIH/NCI Cancer Center Support Grant P30 CA008748. All other authors have nothing to disclose directly related to the article. Statistics and biometry: No complex statistical methods were necessary for this paper. Informed consent: Written informed consent was not required for this study. Ethical approval: Institutional Review Board approval was not required. Study subjects or cohorts overlap: Not applicable. Methodology: Review

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