Breast cancer cases are typically going to involve initially a radiologist and then an oncologist. The radiological expert is necessary to determine whether or not a mammogram was misinterpreted. The oncologist then reviews the materials to determine whether the delay in diagnosis made a significant difference in terms of the patient’s ultimate condition.These are all important players in a medical malpractice claim.
Mammograms can come in the form of plain film or what is called computer assisted detection film, i.e. digitalized film. Plain film is typically read either by one or two radiologists. The digitalized film is interpreted by a radiologist who is assisted by the computer which flags any problems portrayed on the mammogram.
The key principle in interpreting the mammogram is to look for changes in suspicious areas from earlier films. These changes or calcifications may come in a number of different forms. They may come in the form of circles, lines or tight clusters. If the calcifications are round or oval or are scattered and not in tight clusters, then typically they are benign. Even though the calcification may not fit a suspicious pattern if it looks questionable the radiologist should recommend a follow-up mammogram in six months. If the calcification is suspicious, then further study needs to be done either in the form of a diagnostic mammogram, a spot compression, a magnification view, an ultrasound or a biopsy.
If there appears to be negligence in terms of the diagnosis of the cancer, then the next step is to look at the causation issue. Tumors tend to be looked at in terms of size, lymph node involvement and metastasis. The greater the size, the more the lymph node involvement and the existence of metastasis then the more dire the outcome. In evaluating this issue of causation the staging of the cancer can frequently be important. Staging falls into four different levels with stage 1 involving a survival rate of five years at 100% and stage 4 meaning that the survival rate for five years is 20%. If the failure to properly diagnose has resulted in the patient going from stage 1 to stage 4, then the causation element has probably been met. In general, however, it must be established that the improper diagnosis has at the very least destroyed a substantial possibility of the patient surviving. If survival is not the issue, then it typically needs to be established by a preponderance of the evidence (the greater weight of the evidence) that the patient’s condition would have been substantially better than it is now if there had been a prompt diagnosis.
For more information about cancer see the government maintained site.