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Biopsy of Occult Breast Lesions and Professional Liability-Reply

Jack E. Meyer, MD; Marian R. Sonnenfeld, MD; Timothy J. Eberlein, MD; Paul C. Stomper, MD
JAMA. 1990;264(15):1948. doi:10.1001/jama.1990.03450150046026.
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In Reply.—  Dr Darios questions the advisability of not performing a biopsy of innocuous-appearing occult mammographic abnormalities on the basis of a possible malpractice judgment. Despite published and broadly accepted standards, there is unquestionably a wide variation in the criteria used by individual radiologists to support biopsy of an occult breast abnormality. This recommendation is usually based on one or more of the following factors: (1) the degree of experience and confidence of the radiologist in separating benign from malignant abnormalities, (2) the proper utilization of magnification, compression spot films, ultrasound, and/or prior comparison mammograms, and (3) the level of concern over possible litigation when recommending a 6-month follow-up rather than biopsy. Equivocal official mammographic reports diminish the value of the interpretation and almost always result in excision being performed.To orient one's practice strictly toward avoidance of litigation is unfair to our patients. We are certain that Dr Darios


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