Annals of Surgical Oncology

, Volume 25, Issue 10, pp 2801–2806 | Cite as

Ethical Considerations of Medical Photography in the Management of Breast Disease

  • Toan T. NguyenEmail author
  • Lindi VanderWalde
  • Emily Bellavance
  • Thomas Eisenhauer
  • Tina Hieken
  • Nathalie Johnson
  • David I. Kaufman
  • Jennifer O’Neill
  • Caitlin R. Patten
  • Paige Teller
  • Sarah Tevis
  • Terry Sarantou
  • Alyssa Throckmorton
Breast Oncology



Medical photography has become an important component of the evaluation and management of patients across many specialties. It is increasingly utilized in contemporary practice with modern smartphones and enhanced digital media. Photography can enhance and improve treatment plans and communication between providers and patients. Additionally, photography supplements education, research, and marketing in both print and social media. Ethical and medicolegal standards for medical photography, specifically for patients with breast disease, have not been formally developed to guide medical providers.


To provide guidelines for breast care physicians using medical photography, the Ethics Committee of the American Society of Breast Surgeons presents an updated review of the literature and recommendations for ethical and practical use of photography in patient care.


An extensive PubMed review of articles in English was performed to identify studies and articles published prior to 2018 investigating the use of medical photography in patient care and the ethics of medical photography. After review of the literature, members of the Ethics Committee convened a panel discussion to identify best practices for the use of medical photography in the breast care setting. Results of the literature and panel discussion were then incorporated to provide the content of this article.


The Ethics Committee of the American Society of Breast Surgeons acknowledges that photography of the breast has become an invaluable tool in the delivery of state-of-the-art care to our patients with breast disease, and we encourage the use of this important medium. Physicians must be well informed regarding the concerns associated with medical photography of the breast to optimize its safe and ethical use in clinical practice.



The authors thank Dawn Welker and Janice Bloodworth, the librarians from the Bronstein Library at Baptist Memorial Hospital, Memphis, TN, who performed the initial literature search for the manuscript.


  1. 1.
    Palacios-Gonzalez C. The ethics of clinical photography and social media. Med Health Care Philos. 2015;18:63–70.CrossRefGoogle Scholar
  2. 2.
    Burns K, Belton S. “Click first, care second” photography. Med J Aust. 2013;198(1):22.CrossRefGoogle Scholar
  3. 3.
    Cheung A, Al-Ausi M, Hathorn I, et al. Patients’ attitudes toward medical photography in the emergency department. Emerg Med J. 2005;22(8):609.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Lau CK, Schumacher HH, Irwin MS. Patients’ perception of medical photography. J Plast Reconstr Aesthet Surg. 2010;63(6):e507–11.CrossRefGoogle Scholar
  5. 5.
    Segal J, Sacopulos MJ. Photography consent and related legal issues. Facial Plast Surg Clin N Am. 2010;18(2):237–44.CrossRefGoogle Scholar
  6. 6.
    Holt GR. Ethical conduct of humanitarian medical missions: II. Use of photographic images. Arch Facial Plast Surg. 2012;14(4):295–6.CrossRefGoogle Scholar
  7. 7.
    U.S. Department of Health and Human Services. Summary of the HIPAA Privacy Rule. Accessed 27 April 2018.
  8. 8.
    Ault A. Medscape. Smartphone photos in OR not so smart, says privacy expert. 2017. Accessed 16 April 2018.
  9. 9.
    Devakumar D, Brotherton H, Halbert J, et al. Taking ethical photos of children for medical and research purposes in low-resource settings: an exploratory qualitative study. BMC Med Ethics. 2013;14:27.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Harting MT, DeWees JM, Vela KM, et al. Medical photography: current technology, evolving issues and legal perspectives. Int J Clin Pract. 2015;69(4):401–9.CrossRefGoogle Scholar
  11. 11.
    Annals of Surgical Oncology. Instructions for authors. 2017. Accessed 16 April 2018.
  12. 12.
    Van der Rijt R, Hoffman S. Ethical considerations of clinical photography in an area of emerging technology and smartphones. J Med Ethics. 2014;40(3):211–2.CrossRefGoogle Scholar
  13. 13.
    Kunde L, McMeniman E, Parker M. Clinical photography in dermatology: ethical and medico-legal considerations in the age of digital and smartphone technology. Australas J Dermatol. 2013;54(3):192–7.CrossRefGoogle Scholar
  14. 14.
    Landman A, Emani S, Carlile N, et al. A mobile app for securely capturing and transferring clinical images to the electronic health record: description and preliminary usability study. JMIR Mhealth Uhealth. 2015;3(1):e1.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    US Department of Health and Human Services. Texting of patient information among healthcare providers. Accessed 27 April 2018.
  16. 16.
    US Department of Health and Human Services. Summary of the HIPAA security rule. Accessed 27 April 2018.
  17. 17.
    Tomlinson JK, Myers AJ, Meads BM. “Click first, care second” photography [letter]. Med J Aust. 2013;198(1):21–2.CrossRefGoogle Scholar
  18. 18.
    Bhattacharya S. Clinical photography and our responsibilities. Indian J Plast Surg. 2014;47(3):277–80.PubMedPubMedCentralGoogle Scholar

Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Toan T. Nguyen
    • 1
    Email author
  • Lindi VanderWalde
    • 2
  • Emily Bellavance
    • 3
  • Thomas Eisenhauer
    • 4
  • Tina Hieken
    • 5
  • Nathalie Johnson
    • 6
  • David I. Kaufman
    • 7
  • Jennifer O’Neill
    • 8
  • Caitlin R. Patten
    • 9
  • Paige Teller
    • 10
  • Sarah Tevis
    • 11
  • Terry Sarantou
    • 12
  • Alyssa Throckmorton
    • 2
  1. 1.Lakeland Regional HealthLakelandUSA
  2. 2.Baptist Cancer CenterMemphisUSA
  3. 3.Department of SurgeryUniversity of MarylandBaltimoreUSA
  4. 4.Pardee UNC Health CareHendersonvilleUSA
  5. 5.Mayo ClinicRochesterUSA
  6. 6.Legacy Cancer InstitutePortlandUSA
  7. 7.St. Joseph HospitalBethpageUSA
  8. 8.Arizona Breast ConsultantsAvondaleUSA
  9. 9.Department of SurgeryMedical College of WisconsinMilwaukeeUSA
  10. 10.Maine Medical CenterPortlandUSA
  11. 11.MD AndersonHoustonUSA
  12. 12.Department of General Surgery, Levine Cancer InstituteCarolinas Healthcare SystemCharlotteUSA

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