Case Study: A Delay in the Diagnosis of Breast Cancer

Lawsuits commenced against physicians in a variety of medical specialties continue to contain allegations of the failure to timely diagnose breast cancer. Often, the targets of these lawsuits are obstetricians/gynecologists, general surgeons, radiologists and general medical practitioners. Frequent allegations include:

• the failure to take a complete family and medical history;
• poor documentation;
• failure to communicate;
• the failure to review and follow up on abnormal test results;
• misread mammograms;
• the failure to recommend further studies;
• and delayed referrals.

The lead article in MLMIC’s Winter 2017 Case Review illustrates some of these problems. It analyzes a case involving a 53-year-old married mother of three who had a family history of maternal breast and ovarian cancer. The patient was post-menopausal and taking hormonal supplementation.

For one of her annual mammograms, the radiologist’s report noted that additional imaging was recommended for what appeared to be a developing nodule. However, the radiology practice had no documentation that any telephone calls were made or letters were sent to the patient requesting her to return for additional studies. Further, neither her gynecologist nor her internist was contacted about this finding. The gynecologist and his staff did not even realize that a mammography report was outstanding until the patient returned for her annual examination one year later. When the results of a CA-125 test ordered at that time showed elevated levels, the patient was promptly referred to a cancer treatment center. She was subsequently diagnosed with stage IV breast cancer with metastasis to the liver and bone, which originated from the breast.

The patient commenced a lawsuit against both the radiologist and his entity and her gynecologist and his entity. The allegations in the lawsuit included the failure to notify the patient of the need for further mammography studies and the failure of both the gynecologist and radiologist to communicate regarding the abnormal findings seen on the initial mammogram. Finally, the patient alleged that her gynecologist negligently failed to review the radiologist’s report until a year after it had been sent to his office.

In light of these serious problems, the lawsuit was settled by both physicians and their professional entities for a combined $1.85 million. Experts who reviewed this case were particularly concerned that because of the delay in diagnosis, the continuous use of estrogen fueled this cancer. This made the other deficits in her care seem even more egregious. The patient was alive at the time of the settlement. However, she subsequently died of metastatic breast cancer.

For the complete case study, including a more detailed summary of the patient’s medical history and a legal perspective, visit the Winter 2017 Case Review here.