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To assess the incidence and clinical significance of discrepancy in subspecialty interpretation of outside breast imaging examinations for newly diagnosed breast cancer patients presenting to a tertiary cancer center.

This Institutional Review Board–approved retrospective study included patients presenting from July 2016 to March 2017 to a National Cancer Institute–designated comprehensive cancer center for second opinion after breast cancer diagnosis. Outside and second opinion radiology reports of 252 randomly selected patients were compared by two subspecialty breast radiologists to consensus. A peer review score was assigned, modeled after ACR’s RADPEER^TM peer review metric: 1—agree; 2—minor discrepancy (unlikely clinically significant); 3—moderate discrepancy (may be clinically significant); 4—major discrepancy (likely clinically significant). Among cases with …