Breast cancer cases involve a radiologist and also an oncologist. The radiological expert is needed to state whether or not the films were misread. The cancer doctor then reviews all of the material to decide whether or not the delay in seeing the cancer had an effect in terms of the final outcome. These doctors are all players in a breast cancer malpractice claim.
Breast cancer failure to diagnose claims require in-depth study of how breast cancer moves. In these types of claims the first consult with the doctor coupled with some delay in treating the cancer forms the basis for a claim. The first question is when could the cancer have been seen and treated. The next question is what is the likely outcome if it had been seen and treated in a timely way.
In looking at these cases it is important to know the patient’s background:
A common defense in these cases is that even if the cancer had been seen timely, the outcome would still be the same. The best comeback to this defense is a review of the client’s blood levels after treatment. If the blood levels got better then this may be proof that the cancer did respond. Likewise it can be argued that even if the patient did not get better, that may be due to the large size of the tumor.
Films of the breast can come in a number of forms. Plain films are read either by one or two doctors. The digital film is seen not only by a doctor but the computer itself may flag problems.
The key in looking at these films is to look for changes from prior films. These changes may be in the form of circles, lines or tight clusters. If the changes are round, oval or scattered, they may be benign. Even if felt to be benign, there should be a further study in 6 months. If the doctor suspects they are not benign then a further study should be ordered that may involve a tissue sample.
3-D studies have now been approved by the Food and Drug Administration (FDA). These studies are different than the prior 2-D studies. The 2-D studies are helpful in that most doctors know how to read these whereas they may not know how to read a 3-D study.
The 3-D study does involve more radiation. Two studies by the FDA, according to The Washington Post, report that when combined 2-D and 3-D images are looked at there is a 7% chance of a better result in terms of seeing the cancer. The 3-D studies had been found to be helpful in seeing small cancers.
The National Cancer Institute (NCI) states that women over 40 should have breast films taken every one to two years. On the other hand, the U.S. task force assigned to review these issues says that standard should only apply to women over 50.
Patients with early stage breast cancer need to be followed closely. Exams should at least be on an annual basis in terms of films and a breast exam every 6 months. Those patients with early breast cancer who now appear to have been cleared should not have films of any part of the body other than the breast. If the cancer has been missed then the next step is to look at the causation issue. Tumors tend to be looked at in terms of size, whether they involve the lymph nodes and whether they have spread. The greater the size, the more lymph nodes involved and the more the cancer has spread, then the more dire is the outcome.
In staging cancer, there are four levels.
Patients who present with a breast mass two centimeters or smaller (about the size of a dime) and no other signs are generally put into Stage 1. They undergo an aspiration of the mass if it does not go away in 30 days.Stage 1 means the patient will survive at least five (5) years. Stage 4 means that the chance of living for five years is 20%.
If the failure to see and treat the cancer has resulted in the patient going from Stage 1 to Stage 4 then it can safely be said that the negligence was a cause of injury to the patient however it must be proved that the failure to see and treat the cancer has taken away a substantial possibility of the patient surviving. If survival is not the issue then it needs to be shown by the greater weight of the proof that the patient would have been much better than she is now if there had been prompt treatment.
One of the treatment options for breast cancer is breast removal. Another is lump removal. If the tumor is too large, too spread out or if the patient can’t handle radiation then lump removal is not a good option. The lump removal spares most of the breast. It leaves a scar. There is no need to wear a false breast or to rebuild the breast. It does involve 2 to 6 weeks of daily radiation. That may cause shrinking and hardening of the tissue and also itchy and tender skin.
Breast removal normally only requires radiation when the tumor is very large or the cancer cells have spread to the lymph nodes. Some women elect to have breast removal as a safety measure. That is, having the healthy breast removed along with the diseased one. That reduces the risk of future cancer. That is a personal choice, especially since the chance of cancer in the healthy breast is quite low.
In terms of drugs to reduce the risk of cancer coming back after surgery there are many options. Their use depends on age and type of cancer. Tamoxifen does cut the risk of the cancer coming back when taken for up to 5 years but only if the cancer is connected with the female hormone, estrogen. In addition this drug can bring on early symptoms of menopause.
Another option is the aromatase inhibitors which tend to cause fewer problems than Tamoxifen. They can cause bone loss. Only postmenopausal women should take this drug since it shuts down the making of estrogen entirely.
Breast cancer lymph node removal as an option is subject to some debate. At least one study has indicated that the 5 year survival rate was no greater for those women who had the lymph nodes removed than those who did not.
Breast cancer is found in nearly 200,000 women each year in the U.S. Breast cancer reaches the lymph nodes in approximately 1/3 of these cases. The lymph node removal frequently produces disabling swelling in the arms.
The study referenced above was limited to women with tumors known as T1 or T2 which are small tumors and had no enlarged lymph nodes that could be felt and the cancer had not spread elsewhere in the body.
If you have been the victim of medical malpractice in regards to breast cancer diagnosis or treatment contact Brien Roche in Fairfax, Virginia and Washington,DC. For more information on breast cancer see the pages on Wikipedia.
For more information about cancer see the government maintained site.