October is Breast Cancer Awareness Month. As a Board Certified Radiologist and Attorney, I have had the experience of knowing women whose breast cancers, unfortunately, were not diagnosed until it was too late for satisfactory treatment. The breast cancer detection practices are well-publicized: Self-Examination, Regular Physician Breast Exams and Screening Mammograms starting at age 40 or sooner if indicated.
However, there are several simple precautions every woman should take to prevent a doctor’s error from delaying breast cancer diagnosis. Each of the following tips is grounded in some other woman’s misfortune. Hopefully, these tips can prevent a similar misfortune from happening to you.
Always get a copy of your mammogram report. Read the report and file it with your medical records. If there are things you do not understand in your mammogram report, ask your doctor to explain them. Do not rely on your physician’s oral report of his/her interpretation of the mammogram, and certainly don’t rely upon a staff member’s statement over the telephone. Don’t assume that they will call you if anything is abnormal.
Know where your mammogram films are kept, and make certain they are available for the radiologist who is reviewing your current mammogram examination. Finding changes in densities within the breast based on a review of sequential mammograms is as important as detecting a suspicious mass on a mammogram. Because a mammogram is a picture of one moment in time, the information from a single study is limited to the findings on that film. A series of mammograms of the same breast provides much more information about a woman’s risk for breast cancer.
If you are moving out of town, get copies of your mammogram films. Your new doctor will have the benefit of your prior studies for comparison with your most recent examination. Radiologists are only required to keep films for seven (7) years. Unless you obtain the films or copies of the films, the X-ray department will discard your mammograms after the appropriate period of time. Also, take copies of your medical records with you.
No lump should be left in the breast for more than a few months. A palpable lump needs to be evaluated by mammography, ultrasound and biopsy, if necessary, even in women under 30 years of age. Since breast cancers in younger women are more aggressive than those in older women, it is especially important for younger women not to delay in determining whether or not a lump is cancerous.
Just because a breast lump stays the same size doesn’t mean its prognosis remains the same. Prompt diagnosis and treatment of breast cancer is important, even if the mass does not show an increase in size during the delay. Even without observable changes in size, breast cancers can change in their aggressiveness and virulence over time. Waiting to see if a mass grows to determine whether or not to remove it for examination is not a satisfactory way to monitor potential breast cancer. Any delay is sufficient to increase the aggressiveness and potential spread of cancer.
The above tips have been learned through the tragic lessons of others’ misfortunes. With the cost and time pressures on today’s healthcare providers, each woman should follow these tips to prevent an avoidable delay in the diagnosis of breast cancer. A malpractice award for a woman with a delayed diagnosis of breast cancer is no replacement for the lost opportunity to affect her chance for a cure.