Breast Cancer

Fairfax Injury Lawyer Brien Roche Addresses Breast Cancer Cases

Brien Roche

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 breast cancer medical malpractice claim.

Breast Cancer Failure To Diagnose

Breast cancer failure to diagnose claims require a detailed knowledge of the physiology of breast cancer. In these type of medical malpractice claims typically, it is the initial consultation with the doctor coupled with some delay in diagnosing and treating the cancer that forms the basis for a claim. The average delay in diagnoses is 14 months across the board. In evaluating the case the principal inquiry is when could the cancer have been diagnosed and what the probable outcome would have been if diagnosed in a timely fashion.

Patients who present with a breast mass that is approximately 2 centimeters or smaller (about the size of a dime) and no other symptoms are generally categorized into Stage I. It is essential that these patients undergo an aspiration of the breast mass if it does not resolve within 30 days.

In evaluating these medical malpractice cases it is important to know the patient’s history, that is:

  • Any family history of breast cancer
  • Child bearing history. The absence of any child bearing is a potential risk factor to be considered.
  • Any prolonged exposure to environmental factors that may be linked to breast cancer.
  • Did the patient seek a second opinion after the initial consultation?
  • Has the patient maintained some regularity of visits with the same physician?
  • Does the patient regularly engage in self-examination?

A common defense in these cases is that even if the cancer had been timely diagnosed the outcome would not have been any different. The best comeback to this defense is an interpretation of the client’s blood chemistry levels after treatment such as chemotherapy. If the blood chemistry levels improved, then this may be evidence that the cancer did in fact respond to treatment. Likewise, it can be argued that even if there was no improvement that may be due to the increased size of the tumor.

Breast Cancer and Mammograms

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. 

Breast Cancer Staging

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.

Breast Cancer Information

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Breast Cancer

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Contact Us For A Free Consultation