The allegation of a delay in the diagnosis of breast cancer remains the most prevalent cause for which radiologists are sued for medical malpractice. Although some data indicate that the absolute number of malpractice lawsuits alleging missed mammographic diagnoses has stabilized or may be slightly decreasing, the average indemnification paid in such cases is rising. However, with the number of mammographic examinations performed annually in the United States likely to increase, it is probable that the number of related malpractice lawsuits will begin to rise accordingly. The two issues at stake in lawsuits alleging delay in the diagnosis of breast cancer are whether the radiologist has been negligent in his or her interpretation of mammography, and whether the alleged delay in diagnosis has adversely affected the patient's treatment or prognosis. At trial, these issues are decided by a jury; in settlement discussions, these issues are decided by attorneys representing the plaintiff and defendants, and by claims managers of professional liability insurance companies. In either event, the testimony of radiologists retained as expert witnesses by the various parties in the lawsuit heavily influences final resolution. Jurors, attorneys, insurance claims managers, patients, and doctors are all members of the public at large, and thus all are influenced in varying degrees by the voluminous medical information to which the public is exposed by the print and broadcast news media. In this way perceptions - and misperceptions - are formed. It is likely that medical malpractice lawsuits alleging delay in the diagnosis of breast cancer are more frequent and result in disproportionately greater indemnification because the public perceives mammography to be unrealistically accurate and effective in improving prognosis. Perhaps the material presented in this and similar articles can assist patients who believe they have been subjected to malpractice and their attorneys, radiologists who believe they are unfairly accused of malpractice for misinterpreting mammography and their legal counsel, and radiology experts who may testify in malpracice cases. Perhaps the resource material presented in these articles can help guide all parties into reaching a fair and equitable resolution of these kinds of lawsuits. Perhaps radiology organizations such as the American College of Radiology, the Radiological Society of North America, and the American Roentgen Ray Society, and public interest organizations such as the American Cancer Society should consider undertaking efforts that would educate the public to the fact that mammography may not be as accurate as initially thought, that early diagnosis of breast cancer does not necessarily guarantee a cure, and that failure to diagnose breast cancer earlier does not necessarily result in a poorer prognosis. The time to educate the public about the benefits of screening mammography has been well spent. Is it now time to educate the public about the limitations of mammography?
