Terminal Breast Cancer Missed Due to Improper Screening Protocol

    This case involves a forty-six-year-old female patient who suffered from stage IV metastatic breast cancer. At the age of forty-one, the patient felt some transient pain in her right breast, which prompted a visit to her OBGYN. The doctor ordered an ultrasound that reported benign cystic lesions in the upper central breast. The patient was then referred to a breast surgeon for evaluation and to see if a mammogram was needed. The breast surgeon examined the patient, found no suspicious lesion, and confirmed that there were benign cystic lesions in the upper right breast. The surgeon recommended that the patient should get a mammogram at age forty-five. There were numerous, subsequent visits by the patient to both the OBGYN’s office and to the breast surgeon, with multiple medical note entries stating that a mammography was to be done at age forty-five. The mammogram, however, was not done until the patient was forty-six years old. When the mammogram was performed, she was immediately worked up and diagnosed with Stage IV breast cancer.

    Question(s) For Expert Witness

    • 1. What is the standard screening protocol in regards to mammography?

    Expert Witness Response E-001236

    There are 2 types of mammography examinations: screening and diagnostic. Screening mammography is done in asymptomatic women. Early detection of small breast cancers by screening mammography greatly improves a woman’s chance for successful treatment. Screening mammography is recommended every one to two years for women once they reach forty years of age and every year once they reach fifty years of age. In some instances, physicians may recommend beginning screening mammography before age 40 (eg, if the woman has a strong family history of breast cancer). Studies have shown that regular mammograms may decrease the risk of late-stage breast cancer in women eighty years of age and older.

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