Patients who have an equivocal result or require repeats should have a face-to-face consultation to clearly discuss the need for further tests and possible outcomes and a simple care plan put together. Believe it or not, the need of additional investigation is the first and most common cause of the failure of efficient communication between the diagnostic team and the woman. The forces encountered here are the unexpected present and the unpredictable future. Factors to be taken into consideration are predictability and prudence.

Predictability. In most cases, clinicians should not postpone counseling to the definitive results but prepare woman to the most likely outcome, within a reasonable range of lesions. On the other hand, it is well known they are able to intuitively consider all factors at all times, even while they are seeing the patient and formulating diagnostic hypothesis. This “reflection during action” is the process the doctor uses when dealing with specific, unique, uncertain, and complex situations. These are situations where knowledge is the major requisite, but also skills and attitudes, which make of medicine an art.

Prudence should have a big part in the above process. It refers mainly to subjective “physician-centered” knowledge and experience to make a medical diagnosis and devise a treatment plan. However, another component should be “patient-centered” and define the factors related to patient’s psychology and sociology. For someone, this component is better called humanity but more simply is a professional duty.

At the slightest suspect of cancer, some women live the doubt as if the diagnosis were certain, and delays at any stage of the diagnostic process may result in anxiety for the woman, which sometimes may be considerable.

Where delay may arise, a definite timetable should be set for each step of the process in terms of working days (w.d.). According to Eusoma [2], quality assurance in the diagnosis of breast disease is guaranteed by the realization of the following indicators:

Besides time frames, the radiologist should be present in the clinic at the time when a woman has her mammogram so that any necessary further investigation (e.g., magnification or spot compression views, ultrasound examination) can be performed without delay. As far as possible, the woman should be informed of the result of her examination before she leaves the clinic and of the need for any necessary further investigation to be performed.

For patients who undergo needle biopsy, both written and verbal information should be provided. All patients who undergo needle biopsy should be provided with a definite appointment or other agreed arrangement for communication of the biopsy result, within 5 working days, so they can arrange to be accompanied by family/friend if they wish.

The failure of the assessment process to make a definitive diagnosis of either a benign or a malignant condition is an undesirable outcome of assessment and further increases anxiety. For this reason, the use of early recall for a repeat examination at a time shorter than that normally specified for a routine follow-up is to be avoided.

Women must be informed of time limit to expect results and should be provided with written information at appropriate stages in the diagnostic procedure. However, information regarding the likelihood of malignancy being present should not be given via telephone or letter. Such information should be given verbally to the woman, preferably in the presence of a relative or a nurse counselor.