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Rates and Causes of Disagreement in Interpretation of Full-Field Digital Mammography and Film-Screen Mammography in a Diagnostic Setting

Luz A. Venta1,2, R. Edward Hendrick1, Yolanda T. Adler1, Patricia DeLeon1, Patricia M. Mengoni1, Anna Marie Scharl1, Christopher E. Comstock1,3, Lori Hansen1, Nicole Kay1, Andrew Coveler1 and Gary Cutter4

1 Radiology Department, Lynn Sage Comprehensive Breast Center, Northwestern University Medical School, Galter Pavilion, 13th Floor, 251 E. Huron St., Chicago, IL 60611-2923.
2 Present Address: Baylor Methodist Breast Care Center, 6550 Fannin St., 7th Floor, Ste. 701, Houston, TX 77030.
3 Present Address: West Suburban Hospital, Three Erie Ct., Oak Park, IL 60302.
4 AMC Cancer Research Center, 1600 Pierce St., Denver, CO 80214.



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  		Fig. 1A. —49-year-old woman who presented to diagnostic center with no clinical complaints. Film-screen mammogram (not shown) was interpreted as having normal findings. Photographic magnification of full-field digital mediolateral mammogram after electronic magnification reveals faint cluster of indeterminate microcalcifications (arrow) in lower breast. Cluster was not visible, even retrospectively, on film-screen mammography. Patient was called back on basis of full-field digital mammography results and underwent biopsy for microcalcifications with stereotactic guidance.

 


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  		Fig. 1B. —49-year-old woman who presented to diagnostic center with no clinical complaints. Film-screen mammogram (not shown) was interpreted as having normal findings. Radiograph shows multiple microcalcifications in several core specimens. Pathology found ductal carcinoma in situ, cribriform morphology, 3.5 mm, grade 1 of 3.

 


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  		Fig. 2A. —47-year-old woman who presented for examination of indurated area around right nipple. Mediolateral full-field digital mammogram reveals normal-appearing tissue.

 


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  		Fig. 2B. —47-year-old woman who presented for examination of indurated area around right nipple. Craniocaudal digital mammogram reveals focal nodularity medial to nipple (arrow). This mammogram was interpreted as showing normal findings.

 


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  		Fig. 2C. —47-year-old woman who presented for examination of indurated area around right nipple. Magnified spot compression film-screen mammogram in craniocaudal projection confirms spiculated mass. Pathology found infiltrating lobular carcinoma, 2.5 cm, grade 2 of 3.

 

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