Oncology Expert Witness Advises on Delayed Treatment of Breast Cancer

Case Overview

An oncology expert witness advises on a case involving a 46-year-old female patient with a known medical history of early stage breast cancer. The cancer was surgically excised, and the patient had been monitored fairly closely since. She was found to have elevated tumor markers, significant abdominal pain, and documented weight loss. A CT scan of the lower abdomen revealed liver metastasis. A CT-guided liver biopsy confirmed she had spindle cell carcinoma of the breast. The patient was prescribed Lupron, and continued to complain of weight loss, nausea, fatigue and abdominal pain. She underwent an upper endoscopy and was informed that the findings were unremarkable. She was later evaluated and tumor markers were even higher than they had been previously. It is alleged that she was not informed of her elevated tumor markers during a follow up examination that year. The plaintiff claims there was a failure to timely administer appropriate treatment for cancer (i.e., performing surgery to remove the cancerous mass in this instance. The patient is terminally ill and undergoing chemotherapy using Taxotere at present.

Questions to the Oncology expert and their responses

Given the presence of elevated tumor markers in a patient with this clinical profile, would a more thorough follow up have been warranted?

I am well aware of the proper procedures and protocol following the discovery of elevated tumor markers, and use tumor markers frequently to follow BC & MBC patients. Information about tumor markers and other pertinent findings must be conveyed to patients in a timely fashion - meaning, as soon as the information has been received. At the very least, any oncologist would agree that this information ought to be shared with patients during routine, scheduled follow-up visits, which given this patients profile, would occur quite often.

Do you routinely treat patients with a similar profile to the one described in this case?

I am an expert in breast cancer and have seen numerous patients with a similar presentation in a clinical setting throughout the course of my career.

Would earlier intervention have resulted in a better outcome for this patient?

Earlier treatment and intervention favors the patient in this scenario.

Have you ever served as an expert witness on a case similar to the one described above?

I've also seen malpractice claims (as a reviewing expert) similar in nature to the case described.

About the expert

This double board certified internal medicine and oncology expert has been practicing for over 20 years at some of the world's most prestigious medical institutions. He completed his fellowship in medical oncology at the Dana-Farber Cancer Institute, and holds membership in numerous medical associations and societies. He has also authored more than 150 publications in the field of medical oncology. This expert is currently an associate director at a comprehensive breast cancer center and a professor/academic director of oncology at a top university medical center, among other top roles in the field.