Misread mammogram: A mammogram is only as good as the person who takes the film and interprets it. The interpretation is improved if the mammographer compares the most recent study with prior studies side-by-side. If a mammogram is suspicious, follow-up studies, such as a targeted sonogram, core or surgical biopsy, or other studies, may be needed. Sometimes mammograms are correctly interpreted, but the interpretation is not conveyed to the doctor properly, or the report may be lost, misfiled, or filed away without being read.
Inadequate history taking: Too often physicians overlook obvious warning signs, because they did not ask the right questions. Your doctor needs to talk - and listen - to you. He has a duty to teach you to perform self breast examinations, to make sure that you are performing them monthly, and to ask whether you found any suspicious masses. Your physician should be asking good questions to get a sense of your breast cancer risk. If your mother or other blood relatives had breast cancer, you are at a greater risk. If you have pain or discharge from your nipple, particularly bloody drainage, or any concerns your doctor should know and follow-up to find out why.
Cursory Physical Examination: Breast examinations should involve palpation of the entire breast and the arm pit. Masses in the arm pits, and on the periphery of a breast, especially a larger breast, are often missed. The physician should have you stand in front of him and look for symmetry and for puckering, and should check for discharge from the nipple.
Assumptions: Too often physicians assume that only women over the age of fifty with a family breast cancer history are at risk; but young women can get breast cancer, and so can men. A physician have felt a lump and because it was smooth, freely mobile, and/or because he knew the woman had fibrocystic breast disease, a physician may have assumed that the lump is a cyst. Cancers can occur along with fibrocystic breast disease.
Administrative errors: Lost test results, abnormal test results that get filed away uread or unheeded, failure to follow-up on inadequate or inconclusive examinations due to miscommunications, mislabeled specimens, etc., can result in a delay in diagnosis.
Cost-saving measures: Some health plans give physicians financial incentives to not refer their patients to specialists or order diagnostic tests. If you are in a health maintenance organization or a health plan with "capitation" you are at risk from a doctor who is motivated to cut costs at the risk to your health.
To ensure timely diagnosis, the following guidelines should be followed:
Assessments should be thorough, accurate and complete;·
Every breast complaint should be appropriately evaluated; ·
Established breast cancer screening guidelines should be adhered to;
Pre-menopausal women should be referred for evaluation of any breast mass that persists through a menstrual cycle;
Asymmetric breast findings should be considered as a cause for concern and in need of follow-up;
Treatment plans should be made and follow- up interventions should be timely;
Documentation should include a thorough medical history and physical assessment, clinical impression, and follow- up plans.
Office tracking systems for cancer screening & testing follow-up should be utilized
The most common allegations of negligence in breast cancer cases include your physician or medical provider's failures such as:
Delayed diagnosis can lead to significant damages. If the mass had been diagnosed early and properly treated, you may have avoided the complications of treatment, such as disfiguring surgeries, spread of disease that changes prognosis and chance of cure, dissection under the arm that results in lymphedema, life altering chemotherapy regimens and radiation regimens, severely diminished quality of life, or even death.
Breast cancer is the most common malignancy in women and the second leading cause of death due to cancer in women. A complete and thorough medical history and physical examination, health maintenance plus appropriate supplemental diagnostic testing as indicated, with timely treatment plans and follow-up interventions can significantly improve a practitioner’s ability to avoid diagnostic errors.
If you fear that substandard medical care or outright errors resulted in a delay in detecting your cancer, or caused complications in your cancer care that hurt your chance of recovering, I will look at your case free of charge, and tell you if you may have been the victim of medical malpractice. If your case is outside our jurisdiction, we can help you to find skilled and ethical counsel in your area.
Mark R. Bower, Esq
Law Offices of Mark R. Bower, PC