[Study on the management of patients following detection of a "probably benign" mammographic abnormality (ACR BI-RADS category 3): a review of 176 radiologists].

OBJECTIVES

To evaluate mid-term management of patients with category 3 findings (probably benign, ACR BI-RADS) at mammography three months after a CME course on breast cancer.

METHODS

A questionnaire (33 items) was sent to 529 radiologists, three months after the CME course (May-December 2002). The answers were analysed using the chi-square test.

RESULTS

A total of 176 radiologists completed the questionnaire; 63 were part of an organized screening mammography program; 162 used the BI-RADS classification. In the presence of a class 3 finding, 158 radiologists recommended short term follow-up, 28 recommended biopsy, 9 upgraded the level of abnormality, 116 consulted another radiologist, 42 consulted an expert mammographer, 36 submitted the case to a multidisciplinary committee and 12 asked for an overread. Management with short term interval follow-up was worrisome to 91 radiologists for fear of unfavorable outcome, and to 47 radiologists because of possible litigation. Twenty-six radiologists had difficulty explaining to patients the need for short term follow-up. The median score for perceived stress by the radiologists was 3 (0=low and 10=high).

CONCLUSION

The practices of this sample of French radiologists are consistent with the recommendations presented during the CME course and by the ANAES. They may have some difficulty in communicating with patients the need for follow-up. The ethics of radiology are based on "primum non nocere".