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Over 200,000 women are diagnosed with breast cancer every year, and more than 40,000 women die from the disease annually. Breast cancer is notoriously difficult and complicated to treat, with many physicians recommending a combination of surgery, radiation therapy, chemotherapy, or hormone therapy based on the specifics of the cancer, making early detection extremely important. In our firm’s over 50 years of experience representing the victims and survivors of medical malpractice, we have recognized that the failure to diagnose breast cancer usually results from one or more of four main types of negligence by physicians.
First, because breast cancer risk is so strongly correlated with a patient’s family history, genetics and risk factors, it is essential that ever woman’s primary care physician and gynecologist obtain a complete medical history, including by identifying any relatives – whether part of the patient’s immediate family or further out – who have been diagnosed with any form of breast cancer or ovarian cancer. A detailed family history is essential in determining how a patient should be followed and counseled on their options. Women whose family history includes more than one relative diagnosed with breast cancer should be counseled to have a blood test performed to see if they have the BRCA-1 or BRCA-2 gene, which can reduce the body’s ability to fight tumors, and thereby make a woman much more likely to develop breast cancer and for that breast cancer to metastasize to other organs, like the lungs or the spine. Women with one of the BRCA genes also should have prophylactic mastectomies recommended to them so that they know the full availability of treatment options.
Second, although public health campaigns stress to women the need to examine themselves for lumps in their breasts or unexplained discharges from their nipples, doctors sometimes fail to follow-up on this reporting by patients. Even if a primary care physician is unable to find a lump described by the patient during a breast examination, the doctor should nonetheless continue to follow-up on the possibility of breast cancer until they can assure themselves that the patient does not have any abnormalities. For example, even if a doctor cannot find a lump reported by the patient in the doctor’s examination, the doctor should perform or schedule an ultrasound to take a closer look at the possibility that the lump is a tumor or other potentially cancerous growth.
Third, because the screening, diagnosis, and treatment for breast cancer can involve so many different physicians – from a primary care physician, to a radiologist, to an oncologist – proper communication among all physicians is essential. In many medical malpractice cases, the primary care physician recognized the possibility of a problem, but then only ordered a screening mammogram rather than a diagnostic mammogram. In a screening mammogram, the radiologist has not been asked to look at any particular section of the breast, but instead is generally examining the whole area for any unusual areas. In a diagnostic mammogram, however, the referring physician has pointed out to the radiologist an area of concern, which then should prompt the radiologist to examine that area more carefully. Similarly, if a patient has progressed from a mammogram to a biopsy or a mastectomy, then it is essential that the radiologist, surgeon, and primary care physician all remain in close contact about the exact nature of the biopsy and mastectomy performed to ensure that every area of concern has been addressed and to ensure that, in the future, areas which have not been addressed will be monitored carefully.
Fourth, many breast cancer misdiagnosis cases revolve around something as simple and tragic as the failure to read a test correctly. Sometimes a primary care physician appropriately performs an ultrasound after a patient reports finding a lump, but the physician fails to recognize that lump on the ultrasound. Other times, a full mammogram is performed, but the radiologist improperly characterizes a cancerous tumor as an infection or other inflammation. In some cases, a biopsy is performed, but the results are never appropriately reported to the surgeon or any others involved in the patient’s care, leading many of the physicians to improperly assume the biopsy is negative.