Responsabilité du radiologue premier lecteur dans le dépistage organisé du cancer du sein : point de jurisprudence

The responsibility of the radiologist first screen reader in the organized breast cancer screening is carried out in a particular context since the women that are called for screening by the management structure or by their primary care physician or specialist in gynaecology do not a priori present clinical symptoms and are healthy. In this public health approach to secondary prevention, the report has risks that should be particularly considered. The valuation of loss by the insurance company MACSF on three consecutive years (2011, 2012 and 2013) shows that a hundred claims are reported per year per 3000 members. The majority of the claims relates to private practice, which is linked to the fact that organized breast cancer screening is mainly provided by private practionners and radiologists thanks to a territorial network access and proximity. The breast imaging activity is responsible for 20% of the disputes. The radiologist first screen reader is responsible for the entire care of women participating in organized screening of breast cancer. But the specifications of the organized screening of breast cancer assures the first screen reader as a radiologist legal protection, where he can prove that he has complied with the procedure requirements; moreover, the second reading gives it extra security. The responsibility of the first reader radiologist in ten points: (1) he is responsible for the free and enlightened information on the benefits of organized screening; (2) he is responsible for the indication of the screening and shares coresponsibility with the prescribing physician(s); (3) he is responsible for the identity-vigilance; (4) it is responsible for maintaining the quality and quality checks of equipment and systems used; (5) he is responsible for the training of staff employed; (6) he is responsible for the quality of the screening process; (7) he is responsible for the interpretation of exams; (8) he is responsible for the actions to be taken and must ensure their understanding; (9) he is responsible for the transmission of results to the corresponding physicians designated by the patient and the management structure; (10) he is responsible jointly with the management structure and the prescribing physician(s) of the positive patients' follow-up.